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Individual

ELLIS GRANT THOMPSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
BCBA

Contact information

Practice address
1313 NE 134TH ST STE 110, VANCOUVER, WA 98685-2721
(360) 518-6249
Mailing address
5502 NE 74TH AVE, VANCOUVER, WA 98662-6386
(206) 854-1829

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-14-10323

Other

Enumeration date
04/29/2015
Last updated
06/03/2019
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