Provider Demographics
NPI:1013888403
Name:WEBER, BAILEY MARIA
Entity type:Individual
Prefix:
First Name:BAILEY
Middle Name:MARIA
Last Name:WEBER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7400 SW BARNES RD APT 682
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-7024
Mailing Address - Country:US
Mailing Address - Phone:360-836-1947
Mailing Address - Fax:
Practice Address - Street 1:108 SE 124TH AVE STE 22
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-6015
Practice Address - Country:US
Practice Address - Phone:360-836-1947
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-17
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist