Provider Demographics
NPI:1225442494
Name:GEORGE-RAY, AMANDA LYNN (MED, BCBA)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:LYNN
Last Name:GEORGE-RAY
Suffix:
Gender:F
Credentials:MED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27521 NE 140TH PL
Mailing Address - Street 2:
Mailing Address - City:DUVALL
Mailing Address - State:WA
Mailing Address - Zip Code:98019-6308
Mailing Address - Country:US
Mailing Address - Phone:206-778-9554
Mailing Address - Fax:
Practice Address - Street 1:1229 MADISON ST STE 1550
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3586
Practice Address - Country:US
Practice Address - Phone:206-215-6106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-16
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst