Healthcare Provider Details

I. General information

NPI: 1144577966
Provider Name (Legal Business Name): KAYLA DAWN BAYER M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2012
Last Update Date: 11/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 NE OAK VIEW DRIVE SUITE B
VANCOUVER WA
98662-6157
US

IV. Provider business mailing address

8606 NE 34TH WAY
VANCOUVER WA
98662-6157
US

V. Phone/Fax

Practice location:
  • Phone: 360-567-2211
  • Fax: 360-567-2212
Mailing address:
  • Phone: 360-624-2279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMC60317567
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: