Provider Demographics
NPI:1811403074
Name:NEHR, JENNIFER GAYE (RBT)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:GAYE
Last Name:NEHR
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18553 NW STAVIS BAY RD
Mailing Address - Street 2:
Mailing Address - City:SEABECK
Mailing Address - State:WA
Mailing Address - Zip Code:98380-9503
Mailing Address - Country:US
Mailing Address - Phone:206-390-2021
Mailing Address - Fax:
Practice Address - Street 1:18553 NW STAVIS BAY RD
Practice Address - Street 2:
Practice Address - City:SEABECK
Practice Address - State:WA
Practice Address - Zip Code:98380-9503
Practice Address - Country:US
Practice Address - Phone:206-390-2021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-22
Last Update Date:2017-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60769822106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA60769822Medicaid