Provider Demographics
NPI:1730635830
Name:SCHOOLEY, JESSICA
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:SCHOOLEY
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 1:4009 BRIDGEPORT WAY W STE D
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98466-4326
Mailing Address - Country:US
Mailing Address - Phone:253-242-5901
Mailing Address - Fax:
Practice Address - Street 1:4009 BRIDGEPORT WAY W STE D
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98466-4326
Practice Address - Country:US
Practice Address - Phone:253-242-5901
Practice Address - Fax:253-881-7996
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-29
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60936946101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health