Provider Demographics
NPI:1144577966
Name:BAYER, KAYLA DAWN (MA)
Entity Type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:DAWN
Last Name:BAYER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8606 NE 34TH WAY
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-6157
Mailing Address - Country:US
Mailing Address - Phone:360-624-2279
Mailing Address - Fax:
Practice Address - Street 1:9300 NE OAK VIEW DRIVE
Practice Address - Street 2:SUITE B
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-6157
Practice Address - Country:US
Practice Address - Phone:360-567-2211
Practice Address - Fax:360-567-2212
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-10
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
WAMC60317567101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor