| Bayside Autism Therapies, Llc | |
|
1104 Donovan Ave Bellingham WA 98225-7325 | |
| (425) 429-4793 | |
| Not Available |
| Full Name | Bayside Autism Therapies, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1104 Donovan Ave, Bellingham, Washington |
| Authorized Official Name and Position | Tina R Tarver (OWNER) |
| Authorized Official Contact | 4254294793 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bayside Autism Therapies, Llc 1104 Donovan Ave Bellingham WA 98225-7325 Ph: (425) 429-4793 | Bayside Autism Therapies, Llc 1104 Donovan Ave Bellingham WA 98225-7325 Ph: (425) 429-4793 |
| NPI Number | 1255865135 |
|---|---|
| Provider Enumeration Date | 04/17/2017 |
| Last Update Date | 04/17/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255865135 | NPI | - | NPPES |
| 2065537 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 11520651 (Washington) | Primary |
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