Individual
JENNIFER BAUTISTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1210 SW 136TH ST, BURIEN, WA 98166-1214
(206) 257-6600
Mailing address
1210 SW 136TH ST, BURIEN, WA 98166-1214
(206) 257-6600
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
61041258
WA
Other
Enumeration date
05/11/2021
Last updated
05/11/2021
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