Provider Demographics
NPI:1740779107
Name:GREAGER, ERIN BRYCE (MED, BCBA)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:BRYCE
Last Name:GREAGER
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 1:325 GROW AVE NW
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110-1735
Mailing Address - Country:US
Mailing Address - Phone:206-697-0982
Mailing Address - Fax:
Practice Address - Street 1:325 GROW AVE NW
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98110-1735
Practice Address - Country:US
Practice Address - Phone:206-697-0982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-01
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1-14-17210103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty