Gerry Lee Bailey, CG 60801682
Individual provider Active NPI Peer Specialist · Longview, WA
NPI 1497318067 · NPPES record last updated Jan 20, 2020
Key facts
- NPI
- 1497318067
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Peer Specialist 175T00000X
- Practice address
- 1338 Commerce Ave # H
Longview, WA 98632-3732 - Phone
- (306) 261-6930
- NPI assigned
- Apr 18, 2019
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60801682 | WA | MD | Case Manager/Care Coordinator |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | 60801682 | WA | |
| Peer Specialist | 175T00000X | Yes |
Addresses
Primary practice location
1338 Commerce Ave # H
Longview, WA 98632-3732
Mailing address
748 14TH Ave
Longview, WA 98632-2315
Phone (360) 200-5419
Other providers in Longview, WA
- Kyle Nathan Backer
- Hanna Badger
- Sholeh Bagheri
- Suhail Bahu
- Kelly Baierl
- Amanda Elaine Baker
- Nicole Layne Baker
- Sadie Baker
- Tabitha L Baldwin
- Malea Ball
All providers in Longview, WA · Peer Specialist in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 20, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.