Jessa Nicole Bame, MSW

Key facts

NPI

1629638150

Entity type

Individual (NPI type 1)

Primary specialty

Social Worker 104100000X

Practice address

919 S 2ND Ave
Walla Walla, WA 99362-4114

Phone

(509) 529-6036

Fax

(509) 529-6038

NPI assigned

Jun 17, 2019

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 24, 2024.

{
    "created_epoch": "1560729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1629638150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4529 SCHOOLHOUSE RD",
            "city": "BATAVIA",
            "state": "OH",
            "postal_code": "451031005",
            "telephone_number": "513-934-6800",
            "fax_number": "513-752-9181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 S 2ND AVE",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993624114",
            "telephone_number": "509-529-6036",
            "fax_number": "509-529-6038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAME",
        "first_name": "JESSA",
        "middle_name": "NICOLE",
        "name_prefix": "Miss",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-17",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Walla Walla, WA · Social Worker in Washington