Provider Demographics
NPI:1427716778
Name:BUCSKO, JALYN A (LMT)
Entity type:Individual
Prefix:
First Name:JALYN
Middle Name:A
Last Name:BUCSKO
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2651 NW 56TH ST APT 1F
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-4199
Mailing Address - Country:US
Mailing Address - Phone:360-763-2004
Mailing Address - Fax:
Practice Address - Street 1:2651 NW 56TH ST APT 1F
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-4199
Practice Address - Country:US
Practice Address - Phone:360-763-2004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-03
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral