Provider Demographics
NPI:1982190146
Name:HANLEY, BAILEY J
Entity type:Individual
Prefix:
First Name:BAILEY
Middle Name:J
Last Name:HANLEY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:BAILEY
Other - Middle Name:J
Other - Last Name:ROGERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1800 NW MYHRE RD
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-7663
Mailing Address - Country:US
Mailing Address - Phone:564-240-3107
Mailing Address - Fax:564-240-3117
Practice Address - Street 1:1800 NW MYHRE RD
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-7663
Practice Address - Country:US
Practice Address - Phone:564-240-3107
Practice Address - Fax:564-240-3117
Is Sole Proprietor?:No
Enumeration Date:2018-07-10
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW614812641041C0700X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor