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NPI Code Detail

MEDICARE: MR. SEAN AUSTIN BAINBRIDGE

MEDICARE: MR. SEAN AUSTIN BAINBRIDGE
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
1101YM0800XMental Health CounselorWA

General Provider Information

NPI Number : 1083556955
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. SEAN AUSTIN BAINBRIDGE
Provider Business Mailing Address
First Line : PO BOX 95
Second Line :
City : SPANGLE
State : WA
Zip : 99031-0095
Country : US
Telephone Number : 805-377-3890
Fax Number :
Provider Business Practice Location Address
First Line : 4815 N ASSEMBLY ST
Second Line :
City : SPOKANE
State : WA
Zip : 99205-6185
Country : US
Telephone Number : 509-434-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2026
Last Update Date : 04/08/2026

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