Provider Demographics
NPI:1184271504
Name:BAHR, JESSICA ALISON
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:ALISON
Last Name:BAHR
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 1:511 E THOMAS ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-5311
Mailing Address - Country:US
Mailing Address - Phone:253-355-8657
Mailing Address - Fax:
Practice Address - Street 1:33507 9TH AVE S STE H2
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6638
Practice Address - Country:US
Practice Address - Phone:253-347-2579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-20
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist