Healthcare Provider Details

I. General information

NPI: 1225442494
Provider Name (Legal Business Name): AMANDA LYNN GEORGE-RAY M.ED., BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2014
Last Update Date: 10/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1229 MADISON ST STE 1550
SEATTLE WA
98104-3586
US

IV. Provider business mailing address

27521 NE 140TH PL
DUVALL WA
98019-6308
US

V. Phone/Fax

Practice location:
  • Phone: 206-215-6106
  • Fax:
Mailing address:
  • Phone: 206-778-9554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: