Provider Demographics
NPI:1760138911
Name:QUIGG, JENNIFER (MHCAMC61163124)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:
Last Name:QUIGG
Suffix:
Gender:F
Credentials:MHCAMC61163124
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 MARIGOLD DR UNIT 21
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98229-2796
Mailing Address - Country:US
Mailing Address - Phone:925-302-3125
Mailing Address - Fax:
Practice Address - Street 1:1329 N STATE ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4753
Practice Address - Country:US
Practice Address - Phone:360-300-2123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-25
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
WAMC61163124101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health