Provider Demographics
NPI:1699560318
Name:DAVIS, JAYMEN CHARLES (MA)
Entity type:Individual
Prefix:
First Name:JAYMEN
Middle Name:CHARLES
Last Name:DAVIS
Suffix:
Gender:
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 NE 145TH ST APT E103
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98155-7545
Mailing Address - Country:US
Mailing Address - Phone:425-200-2265
Mailing Address - Fax:
Practice Address - Street 1:3430 SW 320TH ST
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98023-2292
Practice Address - Country:US
Practice Address - Phone:253-289-6099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-12
Last Update Date:2025-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health