Individual provider Active NPI

Melissa Grindstaff

  • Behavior Analyst
  • Tukwila, WA
National Provider Identifier
1407217722
Registry record updated Mar 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
15445 53Rd Ave S Ste 110
Tukwila, WA 98188-2326
Phone
(206) 313-8840
Fax
(206) 641-9540
NPI assigned
Mar 14, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

15445 53Rd Ave S Ste 110
Tukwila, WA 98188-2326

Mailing address

5135 Frances Ave NE
Tacoma, WA 98422-1837
Phone (253) 350-3412

Other identifiers 1

IdentifierTypeStateIssuer
111524501MedicaidWA

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

NPI Registry JSON

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

{
    "created_epoch": "1457913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457913600000",
    "number": "1407217722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5135 FRANCES AVE NE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984221837",
            "telephone_number": "253-350-3412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15445 53RD AVE S STE 110",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981882326",
            "telephone_number": "206-313-8840",
            "fax_number": "206-641-9540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRINDSTAFF",
        "first_name": "MELISSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-14",
        "last_updated": "2016-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111524501",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tukwila, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2016; 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.