| Brain Health Northwest | |
|
219 1st Ave S Suite 310 Seattle WA 98104-2575 | |
| (206) 321-1017 | |
| (206) 641-3246 |
| Full Name | Brain Health Northwest |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 219 1st Ave S, Seattle, Washington |
| Authorized Official Name and Position | Richard Lynn Packard (PSYCHOLOGIST) |
| Authorized Official Contact | 2063211017 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brain Health Northwest 219 1st Ave S Suite 310 Seattle WA 98104-2575 Ph: (206) 321-1017 | Brain Health Northwest 219 1st Ave S Suite 310 Seattle WA 98104-2575 Ph: (206) 321-1017 |
| NPI Number | 1669830774 |
|---|---|
| Provider Enumeration Date | 02/03/2016 |
| Last Update Date | 02/03/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669830774 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | CL60528100 (Washington) | Secondary |
| 103TC0700X | Psychologist - Clinical | 1613 (Washington) | Primary |
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