Provider Demographics
NPI:1831834001
Name:WHITE, JAYLYN (MA)
Entity type:Individual
Prefix:
First Name:JAYLYN
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:JAYLYN
Other - Middle Name:
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:1600 121ST ST SE APT X102
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-7909
Mailing Address - Country:US
Mailing Address - Phone:206-714-7002
Mailing Address - Fax:
Practice Address - Street 1:1600 121ST ST SE APT X102
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-7909
Practice Address - Country:US
Practice Address - Phone:206-714-7002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-02
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling