Provider Demographics
NPI:1649046160
Name:ZINKGRAF, JAMIE (BCBA)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:ZINKGRAF
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1803 E LACROSSE AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99207-4473
Mailing Address - Country:US
Mailing Address - Phone:509-863-8963
Mailing Address - Fax:
Practice Address - Street 1:901 N MONROE ST STE 350
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-2103
Practice Address - Country:US
Practice Address - Phone:509-862-6100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA12369328103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty