Provider Demographics
NPI:1306369467
Name:BATCHELDER, JASMINE
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:BATCHELDER
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 1:2200 RAINIER AVE S STE 201
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98144-4642
Mailing Address - Country:US
Mailing Address - Phone:206-447-9904
Mailing Address - Fax:
Practice Address - Street 1:2200 RAINIER AVE S STE 201
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98144-4642
Practice Address - Country:US
Practice Address - Phone:206-447-9904
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-20
Last Update Date:2021-05-24
Deactivation Date:2021-03-31
Deactivation Code:
Reactivation Date:2021-05-13
Provider Licenses
StateLicense IDTaxonomies
WACG61165181101Y00000X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor