Healthcare Provider Details

I. General information

NPI: 1063335271
Provider Name (Legal Business Name): GRETCHEN ELIZABETH GEIST CBT, LABA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17231 67TH AVE NE UNIT 2102
ARLINGTON WA
98223-6031
US

IV. Provider business mailing address

17231 67TH AVE NE UNIT 2102
ARLINGTON WA
98223-6031
US

V. Phone/Fax

Practice location:
  • Phone: 916-202-2653
  • Fax:
Mailing address:
  • Phone: 916-202-2653
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number61517821
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: