Provider Demographics
NPI:1528421476
Name:MURRAY, JILL (MA, BCBA, LBA)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:MURRAY
Suffix:
Gender:F
Credentials:MA, BCBA, LBA
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:
Other - Last Name:PASTUNINK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12729 NORTHUP WAY
Mailing Address - Street 2:#23
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-1935
Mailing Address - Country:US
Mailing Address - Phone:866-727-8274
Mailing Address - Fax:
Practice Address - Street 1:12729 NORTHUP WAY
Practice Address - Street 2:#23
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-1935
Practice Address - Country:US
Practice Address - Phone:866-727-8274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-29
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1-16-21519103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst