Provider Demographics
NPI:1740753854
Name:JEFFRIES, BRIDGETTE (PMHNP-BC)
Entity Type:Individual
Prefix:DR
First Name:BRIDGETTE
Middle Name:
Last Name:JEFFRIES
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4630 200TH ST SW
Mailing Address - Street 2:SUITE B
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036
Mailing Address - Country:US
Mailing Address - Phone:425-670-0280
Mailing Address - Fax:425-670-0278
Practice Address - Street 1:4630 200TH ST SW
Practice Address - Street 2:SUITE B
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036
Practice Address - Country:US
Practice Address - Phone:425-670-0380
Practice Address - Fax:425-670-0278
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-11
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60909606363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1295396166OtherN/A