Kellie Haruko Kumasaka | Kent, WA • PECOS Search

Kellie Haruko Kumasaka

Behavior Technician

Behavioral Health & Social Service Providers

Attn: Behavioral Health Works 6624 S 196th St., Suite U-107, Kent, WA 98032

PECOS Enrollment

Based on the most recent information from CMS, provider Kellie Haruko Kumasaka does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 35 days ago.

Profile Details

Provider ID
1063007052
Provider Type
Individual
Full Name
Kumasaka, Kellie Haruko
Gender
Female

Sole Proprietor
No
Enumeration Date
3/2/2021
Last Updated
3/2/2021

Contact Information

Practice Location

Attn: Behavioral Health Works 6624 S 196th St., Suite U-107, Kent, WA 98032

Unlisted Fax

Mailing Location

1301 E Orangewood Ave, Anaheim, CA 92805-6807

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 106S00000X Primary	Description Behavior Technician Behavioral Health & Social Service Providers	License Unlisted Issuer