Bagby, Genise Rachelle

Bagby, Genise Rachelle is an sole proprietor health care provider with primary practice located at 15 S Grady Way Ste 634 , Renton WA 98057-3218. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Bagby, Genise Rachelle can be contacted via phone (206) 679-8291.

Contact Information

Primary practice address
15 S Grady Way Ste 634 Renton WA 98057-3218
Phone: (206) 679-8291
Fax: (206) 274-6252
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X CO60705270 Washington
Behavioral Health & Social Service Providers / Mental Health 101YM0800X LH60844525 Washington

Profile Details

NPI number 1710330824
LBN Legal business name Bagby, Genise Rachelle
Credentials MA, LMHC, CDPT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 13th, 2016
Last updated Jan 4th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710330824 NPPES
Washington MEDICAID 2099247

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