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2111 N 30th St Tacoma WA 98403-3318 | |
(253) 212-0750 | |
(253) 507-4613 |
Full Name | |
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Speciality | Psychologist - Clinical |
Location | 2111 N 30th St, Tacoma, Washington |
Authorized Official Name and Position | Neil Mckennon Kirkpatrick (PRESIDENT) |
Authorized Official Contact | 2532120750 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2111 N 30th St Tacoma WA 98403-3318 Ph: (253) 212-0750 | 2111 N 30th St Tacoma WA 98403-3318 Ph: (253) 212-0750 |
NPI Number | 1730424391 |
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Provider Enumeration Date | 12/06/2012 |
Last Update Date | 12/06/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1730424391 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | PY60065530 (Washington) | Primary |
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