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General NPI Number Information
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NPI Number | 1609780444
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Entity Type | Individual
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Provider Name | JESSICA NICOLE BRYANT
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Gender | Female
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Dates
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Enumeration Date | 09/29/2026
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Last Update Date | 09/29/2026
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Provider Practice Location Address
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Address Line | 23511 56TH AVE W STE 105
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City | MOUNTLAKE TERRACE
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State | WA
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Zip | 98043-5285
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Country | US
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Telephone | 206-546-2421
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Fax |
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Provider Business Mailing Address
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Address Line | 2117 N 90TH ST
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City | SEATTLE
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State | WA
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Zip | 98103-4123
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Country | US
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Telephone |
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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 |
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License Number State | NULL
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