Provider Demographics
NPI:1275095424
Name:BAUER, ABIGAIL JOSEPHINE
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:JOSEPHINE
Last Name:BAUER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5206 20TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-3313
Mailing Address - Country:US
Mailing Address - Phone:425-327-6388
Mailing Address - Fax:
Practice Address - Street 1:14434 NE 8TH ST STE 2
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-4146
Practice Address - Country:US
Practice Address - Phone:425-223-5126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-04
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician