Provider Demographics
NPI:1013330406
Name:EARLY INTERVENTION SPECIALISTS
Entity Type:Organization
Organization Name:EARLY INTERVENTION SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:GREVEY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, BCBA-D
Authorized Official - Phone:253-318-4648
Mailing Address - Street 1:PO BOX 14
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98338-0014
Mailing Address - Country:US
Mailing Address - Phone:253-318-4648
Mailing Address - Fax:
Practice Address - Street 1:13709 TWIN LAKES DR E
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:WA
Practice Address - Zip Code:98338-7574
Practice Address - Country:US
Practice Address - Phone:253-318-4648
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-22
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty