Provider Demographics
NPI:1992148175
Name:MULJAT BAILEY, ALESHA MARIE (PHD)
Entity type:Individual
Prefix:DR
First Name:ALESHA
Middle Name:MARIE
Last Name:MULJAT BAILEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3215 NW 72ND ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98117-4729
Mailing Address - Country:US
Mailing Address - Phone:206-850-0498
Mailing Address - Fax:
Practice Address - Street 1:1904 3RD AVE STE 1035
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1123
Practice Address - Country:US
Practice Address - Phone:206-802-2712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-08
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY60309815103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical