Jessica M Bolyard

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

1209 W 1St Ave
Spokane, WA 99201-4101

Phone

(509) 995-3388

NPI assigned

Jan 21, 2014

Last updated

Mar 15, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pacific Northwest Behavior, LLC

  • Behavior Analyst
  • Spokane, WA
  • NPI 1275020547
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1390262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1447673884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10811 E AUGUSTA AVE",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "99206",
            "telephone_number": "509-927-0645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 W 1ST AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992014101",
            "telephone_number": "509-995-3388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLYARD",
        "first_name": "JESSICA",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-21",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "60432533",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Ann Bolo
• Cynthia Karen Bolster, MSN, ARNP
• Megan Bolton
• Morgan Rachelle Bolton, MSW, LSWAIC
• Stephaney Bolton, PEER SPECIALIST
• William M. Bomberger, PA-C
• Ann Victoria Bonacum
• Shalana Michelle Bonar, BA
• Kacey Lynn Bonasera
• Bond Chiropractic Health Center

• Behavior Technician in Spokane, WA
• Providers in Spokane, WA by specialty
• Behavior Technician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.