Active NPI
Jennifer Bautista
- Counselor
- Burien, WA
National Provider Identifier
1508440934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 61041258
- Practice address
- 1210 SW 136TH St
Burien, WA 98166-1214 - Phone
- (206) 257-6600
- NPI assigned
- May 11, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 61041258 | WA | Primary |
Addresses
Primary practice location
1210 SW 136TH St
Burien, WA 98166-1214
Mailing address
1210 SW 136TH St
Burien, WA 98166-1214
Phone (206) 257-6600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61041258 | WA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620691200000",
"number": "1508440934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1210 SW 136TH ST",
"city": "BURIEN",
"state": "WA",
"postal_code": "981661214",
"telephone_number": "206-257-6600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1210 SW 136TH ST",
"city": "BURIEN",
"state": "WA",
"postal_code": "981661214",
"telephone_number": "206-257-6600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAUTISTA",
"first_name": "JENNIFER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-05-11",
"last_updated": "2021-05-11",
"certification_date": "2021-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WA",
"license": "61041258",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burien, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.