Provider Demographics
NPI:1306462379
Name:B.A.N.D.S.
Entity type:Organization
Organization Name:B.A.N.D.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD CERTIFIED BEHAVIOR ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:GRAYDON
Authorized Official - Middle Name:
Authorized Official - Last Name:AGAR
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:206-618-4673
Mailing Address - Street 1:2324 177TH STREET CT E
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98445-4279
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:819 VIRGINIA ST UNIT 1603
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-4425
Practice Address - Country:US
Practice Address - Phone:206-618-4673
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-24
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty