Provider Demographics
NPI:1992197701
Name:BARENG-BARROS, JESSICA ASHLEY (DC)
Entity Type:Individual
Prefix:DR
First Name:JESSICA ASHLEY
Middle Name:
Last Name:BARENG-BARROS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:JESSICA ASHLEY
Other - Middle Name:MIGUEL
Other - Last Name:BARENG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:19987 1ST AVE S
Mailing Address - Street 2:SUITE 102
Mailing Address - City:NORMANDY PARK
Mailing Address - State:WA
Mailing Address - Zip Code:98148-2400
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:19987 1ST AVE S
Practice Address - Street 2:SUITE 102
Practice Address - City:NORMANDY PARK
Practice Address - State:WA
Practice Address - Zip Code:98148-2400
Practice Address - Country:US
Practice Address - Phone:206-824-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-03
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60424097111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor