| |
2271 Ne 51st St Seattle WA 98105-5713 | |
(206) 523-8655 | |
Not Available |
Full Name | |
---|---|
Speciality | Psychiatry & Neurology |
Location | 2271 Ne 51st St, Seattle, Washington |
Authorized Official Name and Position | Gwenyth K Mcconnell (OWNER) |
Authorized Official Contact | 2065238655 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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2271 Ne 51st St Seattle WA 98105-5713 Ph: (206) 523-8655 | 2271 Ne 51st St Seattle WA 98105-5713 Ph: (206) 523-8655 |
NPI Number | 1215567771 |
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Provider Enumeration Date | 01/23/2020 |
Last Update Date | 12/31/2023 |
Certification Date | 12/31/2023 |
Medicare PECOS PAC ID | 7810307253 |
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Medicare Enrollment ID | O20201113000797 |
Identifier | Type | State | Issuer |
---|---|---|---|
1215567771 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
Provider Name | Gwenyth K Mcconnell |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1700959673 PECOS PAC ID: 7719904135 Enrollment ID: I20130210000000 |
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