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NPI 1316356868

NPI 1316356868 : AIMEE BAKEMAN : ISSAQUAH, WA

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General NPI Number Information
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    NPI Number           |    1316356868
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    Entity Type          |    Individual 
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    Provider Name        |    AIMEE BAKEMAN
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/08/2014
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    Last Update Date     |    08/08/2014
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Provider Practice Location Address
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    Address Line         |    1375 NW MALL ST SUITE 8
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    City                 |    ISSAQUAH
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    State                |    WA
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    Zip                  |    98027-8950
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    Country              |    US
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    Telephone            |    425-295-7697
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    21248 SE 260TH ST 
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    City                 |    MAPLE VALLEY
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    State                |    WA
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    Zip                  |    98038-7527
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    Country              |    US
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    Telephone            |    813-841-3239
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    MC60491516
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    License Number State |    WA
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