Provider Demographics
NPI:1124175062
Name:BAYUK, LENORE L (RN, ARNP)
Entity type:Individual
Prefix:
First Name:LENORE
Middle Name:L
Last Name:BAYUK
Suffix:
Gender:F
Credentials:RN, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2214
Mailing Address - Street 2:555 PARK STREET
Mailing Address - City:FRIDAY HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98250-2214
Mailing Address - Country:US
Mailing Address - Phone:360-378-3636
Mailing Address - Fax:
Practice Address - Street 1:555 PARK ST
Practice Address - Street 2:
Practice Address - City:FRIDAY HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98250-7502
Practice Address - Country:US
Practice Address - Phone:360-378-3636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30005270101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA04941OtherREGENCE ID NUMBER