NPIMap

Organization Active NPI

Formations Behavior Therapy

  • Community/Behavioral Health Agency
  • Vancouver, WA
National Provider Identifier
1326546235
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
604176297 Issued in WA
Legal business name
FORMATIONS BEHAVIOR THERAPY
Practice address
6409 E Mill Plain Blvd
Vancouver, WA 98661-7454
Phone
(360) 718-8376
Fax
(833) 972-1949
NPI assigned
Jan 25, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Authorized official

Name
Ellis Grant ThompsonNPI 1487031332
Title
Executive Director
Phone
(360) 718-8376

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 604176297 WA Primary

Addresses

Primary practice location

6409 E Mill Plain Blvd
Vancouver, WA 98661-7454

Mailing address

9700 NE 21St PL
Vancouver, WA 98665-5730
Phone (360) 518-6249

National Provider Directory

National Provider Directory

Locations

6407 E Mill Plain Blvd
Vancouver, WA 98661

1313 NE 134th St
Ste 110
Vancouver, WA 98685
Phone (360) 518-6249

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1516838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741651200000",
    "number": "1326546235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9700 NE 21ST PL",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986655730",
            "telephone_number": "360-518-6249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6409 E MILL PLAIN BLVD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986617454",
            "telephone_number": "360-718-8376",
            "fax_number": "833-972-1949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORMATIONS BEHAVIOR THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-25",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-06",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "ELLIS",
        "authorized_official_middle_name": "GRANT",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "360-718-8376"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WA",
            "license": "604176297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2025; 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.