Individual provider Active NPI

Raychel Graves

  • Behavior Technician
  • Lacey, WA
National Provider Identifier
1023723400
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
61389371 Issued in WA
Practice address
3231 Willamette Dr NE Ste C
Lacey, WA 98516-1378
Phone
(803) 873-1920
NPI assigned
Jan 19, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X 61389371 WA Primary

Addresses

Primary practice location

3231 Willamette Dr NE Ste C
Lacey, WA 98516-1378

Mailing address

9211 Windsor LN NE Apt G106
Olympia, WA 98516-5974

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
61389371WAMDBehavior Technician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1674086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1023723400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9211 WINDSOR LN NE APT G106",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985165974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3231 WILLAMETTE DR NE STE C",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985161378",
            "telephone_number": "803-873-1920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVES",
        "first_name": "RAYCHEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-19",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "WA",
            "license": "61389371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lacey, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.