Basic Information
Provider Information
NPI: 1043876196
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BATRES BONI
FirstName: MONICA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4760 32ND AVE S APT 314
Address2:  
City: SEATTLE
State: WA
PostalCode: 981182267
CountryCode: US
TelephoneNumber: 2065368035
FaxNumber:  
Practice Location
Address1: 3808 S ANGELINE ST
Address2:  
City: SEATTLE
State: WA
PostalCode: 981181712
CountryCode: US
TelephoneNumber: 2064614880
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/14/2019
LastUpdateDate: 05/14/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X WAY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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