Healthcare Provider Details

I. General information

NPI: 1376375675
Provider Name (Legal Business Name): DAVID DANIEL BARAJAS JR. MA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2024
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1728 W MARINE VIEW DR STE 221
EVERETT WA
98201-2094
US

IV. Provider business mailing address

728 W MARINE VIEW DR. STE 221
EVERETT WA
98201
US

V. Phone/Fax

Practice location:
  • Phone: 425-364-6855
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberMC61588623
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMC61588623
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: