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NPI Code Detail

MEDICARE: MRS. BERNADETTE JAMBARO GIPAYA BCBA

MEDICARE: MRS. BERNADETTE JAMBARO GIPAYA BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist
2103K00000XBehavior Analyst61259482WA

General Provider Information

NPI Number : 1003125576
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BERNADETTE JAMBARO GIPAYA BCBA
Provider Business Mailing Address
First Line : 109 POPLAR ST
Second Line :
City : PORT ORCHARD
State : WA
Zip : 98366-2527
Country : US
Telephone Number : 808-351-3469
Fax Number :
Provider Business Practice Location Address
First Line : 600 STEWART ST STE 300
Second Line :
City : SEATTLE
State : WA
Zip : 98101-1257
Country : US
Telephone Number : 855-832-6727
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/01/2010
Last Update Date : 02/02/2022

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