Healthcare Provider Details

I. General information

NPI: 1760143994
Provider Name (Legal Business Name): JEREMIE BIANES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2022
Last Update Date: 03/01/2022
Certification Date: 03/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

VA PUGET SOUND HEALTH CARE SYSTEM 9600 VETERANS DRIVE SW
TACOMA WA
98498
US

IV. Provider business mailing address

8832 ELLSWORTH CT NE
LACEY WA
98516-3883
US

V. Phone/Fax

Practice location:
  • Phone: 253-495-1389
  • Fax:
Mailing address:
  • Phone: 240-695-3911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: