Provider Demographics
NPI:1609405513
Name:MURRAY, SUZANNE (BCBA, LBA)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:MURRAY
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:SUZANNE
Other - Middle Name:
Other - Last Name:HELLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10020 166TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-3010
Mailing Address - Country:US
Mailing Address - Phone:425-499-7202
Mailing Address - Fax:
Practice Address - Street 1:10020 166TH AVE NE
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3010
Practice Address - Country:US
Practice Address - Phone:425-499-7202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-02
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61059797103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst