Provider Demographics
NPI:1639486467
Name:BAY, MAILE (JD, PSYD, MSCP)
Entity Type:Individual
Prefix:DR
First Name:MAILE
Middle Name:
Last Name:BAY
Suffix:
Gender:F
Credentials:JD, PSYD, MSCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7272
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98507-7272
Mailing Address - Country:US
Mailing Address - Phone:360-259-7079
Mailing Address - Fax:844-400-6484
Practice Address - Street 1:2617 12TH CT SW STE B6
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-1023
Practice Address - Country:US
Practice Address - Phone:360-259-7079
Practice Address - Fax:844-400-6484
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-31
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY60144805103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAPY60144805OtherSTATE DEPARTMENT OF HEALTH