Basic Information
| Provider Information | |||||||||
| NPI: | 1528117595 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RINGLE | ||||||||
| FirstName: | JESSICA | ||||||||
| MiddleName: | BHAKTI | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.A,, CDPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1408 GOAT TRAIL LOOP RD | ||||||||
| Address2: | |||||||||
| City: | MUKILTEO | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982752258 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4252585277 | ||||||||
| FaxNumber: | 4252585275 | ||||||||
| Practice Location | |||||||||
| Address1: | 1114 PACIFIC AVE FL 3 | ||||||||
| Address2: | |||||||||
| City: | EVERETT | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982014231 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4252585277 | ||||||||
| FaxNumber: | 4252585275 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/09/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | RC00044774 | WA | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.