Healthcare Provider Details

I. General information

NPI: 1093659948
Provider Name (Legal Business Name): BAILEY HONDA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 04/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2603 BRIDGEPORT WAY W STE I&K
UNIVERSITY PLACE WA
98466-4724
US

IV. Provider business mailing address

7312 N SKYVIEW LN APT J203
TACOMA WA
98406-8502
US

V. Phone/Fax

Practice location:
  • Phone: 253-778-6636
  • Fax:
Mailing address:
  • Phone: 808-895-3719
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMG61605521
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: