Provider Demographics
NPI:1174944722
Name:RIPES, JESSICA (MSW, MHP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:RIPES
Suffix:
Gender:F
Credentials:MSW, MHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9330 59TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-6600
Mailing Address - Country:US
Mailing Address - Phone:702-205-8826
Mailing Address - Fax:
Practice Address - Street 1:8803 50TH AVENUE CT SW APT N307
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-4574
Practice Address - Country:US
Practice Address - Phone:702-205-8826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-29
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225400000X
WA60883713101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner