Sophia Jae Pruitt
Behavior Technician in Maple Valley, WA. Individual provider (NPI-1).
NPI number1497543771
StatusActive
Last updated in NPPESApr 28, 2025
Details
- NPI
- 1497543771
- Entity type
- Individual (NPI-1)
- Name
- Sophia Jae Pruitt
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 28, 2025
- Certification date
- Apr 28, 2025
- Last updated
- Apr 28, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
22415 Se 231st St Ste 10322415Maple Valley, WA 98038-5000
Phone 253-409-5861 · Fax 253-409-5861
Mailing address
22415 Se 231st St Ste B103Maple Valley, WA 98038-5002
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Behavior Technician providers in Maple Valley, WA
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All 106 Behavior Technician providers in Maple Valley · All 575 providers in Maple Valley
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