Chrystal Sapphire Dragonflame | Lynnwood, WA • PECOS Search

Chrystal Sapphire Dragonflame

Behavior Technician

Behavioral Health & Social Service Providers

4100 194th St SW Ste 100, Lynnwood, WA 98036-4613

(425) 426-2761 (818) 345-2345

PECOS Enrollment

Based on the most recent information from CMS, provider Chrystal Sapphire Dragonflame 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 yesterday at 12:57 PM.

Profile Details

Provider ID
1154895464
Provider Type
Individual
Full Name
Dragonflame, Chrystal Sapphire
Gender
Female

Sole Proprietor
No
Enumeration Date
1/20/2019
Last Updated
1/20/2019

Contact Information

Practice Location

4100 194th St SW Ste 100, Lynnwood, WA 98036-4613

Unlisted Fax

Mailing Location

21600 Oxnard St Ste 1800, Woodland Hills, CA 91367-7807

Unlisted Fax

Provider Taxonomies

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