Healthcare Provider Details

I. General information

NPI: 1770171118
Provider Name (Legal Business Name): JAMIE HIBBS LMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/31/2020
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1715 114TH AVE SE STE 203
BELLEVUE WA
98004-6906
US

IV. Provider business mailing address

1715 114TH AVE SE STE 203
BELLEVUE WA
98004-6906
US

V. Phone/Fax

Practice location:
  • Phone: 425-310-2061
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number70099926
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: