Provider Demographics
NPI:1225751555
Name:BENDER, BAYLIE ANN-LOUISE (LMT)
Entity Type:Individual
Prefix:
First Name:BAYLIE
Middle Name:ANN-LOUISE
Last Name:BENDER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2208 W 7TH AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-4864
Mailing Address - Country:US
Mailing Address - Phone:509-619-2633
Mailing Address - Fax:
Practice Address - Street 1:2208 W 7TH AVE APT 2
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-4864
Practice Address - Country:US
Practice Address - Phone:509-619-2633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMA61327411OtherWA LICENSE