Provider Demographics
NPI:1477882181
Name:BAY, JASMINE (LAC, LM, CPM)
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:BAY
Suffix:
Gender:F
Credentials:LAC, LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4123 WOODLAND PARK AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-7919
Mailing Address - Country:US
Mailing Address - Phone:206-547-9696
Mailing Address - Fax:
Practice Address - Street 1:4123 WOODLAND PARK AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-7919
Practice Address - Country:US
Practice Address - Phone:206-547-9696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-09
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60074950171100000X
WAMW60064323176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No176B00000XOther Service ProvidersMidwife