Provider Demographics
NPI:1922592062
Name:HOLLY GRIGSBY, PLLC
Entity Type:Organization
Organization Name:HOLLY GRIGSBY, PLLC
Other - Org Name:HOLLY GRIGSBY, MA, LMHC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:P
Authorized Official - Last Name:GRIGSBY
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMHC
Authorized Official - Phone:206-552-0504
Mailing Address - Street 1:3213 HARBOR AVE SW STE 1
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98126-4600
Mailing Address - Country:US
Mailing Address - Phone:206-552-0504
Mailing Address - Fax:206-590-5922
Practice Address - Street 1:3213 HARBOR AVE SW STE 1
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98126-4600
Practice Address - Country:US
Practice Address - Phone:206-552-0504
Practice Address - Fax:206-590-5922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-21
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60835736101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA260471OtherFIRST CHOICE HEALTH NETWORK