Healthcare Provider Details

I. General information

NPI: 1841700721
Provider Name (Legal Business Name): RAVNEET KAUR GREWAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2017
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30514 25TH PL SW
FEDERAL WAY WA
98023-2347
US

IV. Provider business mailing address

30514 25TH PL SW
FEDERAL WAY WA
98023-2347
US

V. Phone/Fax

Practice location:
  • Phone: 206-653-6686
  • Fax:
Mailing address:
  • Phone: 206-653-6686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License NumberAB61026385
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: