Provider Demographics
NPI:1437421278
Name:MISNER, JESSICA B (PSYD, ABPP)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:B
Last Name:MISNER
Suffix:
Gender:F
Credentials:PSYD, ABPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 112TH AVE NE SUITE 301E
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004
Mailing Address - Country:US
Mailing Address - Phone:206-747-7274
Mailing Address - Fax:425-491-7170
Practice Address - Street 1:1800 112TH AVE NE SUITE 301E
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004
Practice Address - Country:US
Practice Address - Phone:206-747-7274
Practice Address - Fax:425-533-5631
Is Sole Proprietor?:No
Enumeration Date:2012-02-08
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY60236511103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical