Individual ProviderAmbrose Fey WhiteBehavior TechnicianBehavioral Health & Social Service ProvidersPractice Address4100 194th St SW Ste 100, Lynnwood, WA 98036-4613(425) 426-2761(818) 345-2345PECOS EnrollmentBased on the most recent information from CMS, provider Ambrose Fey White does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1174130355Provider TypeIndividualFull NameWhite, Ambrose FeyGenderFemaleSole ProprietorNoEnumeration Date9/30/2020Last Updated9/30/2020Contact InformationPractice LocationPractice Address4100 194th St SW Ste 100, Lynnwood, WA 98036-4613Phone(425) 426-2761FaxUnlisted FaxMailing LocationMailing Address21600 Oxnard St Ste 1800, Woodland Hills, CA 91367-7807Phone(818) 345-2345FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106S00000XPrimaryDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerCode103K00000XDescriptionBehavior AnalystBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer