| |
21601 76th Ave W. Edmonds WA 98026-2100 | |
(425) 640-4000 | |
(425) 640-4450 |
Full Name | |
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Speciality | Psychiatry & Neurology - Psychiatry |
Location | 21601 76th Ave W., Edmonds, Washington |
Authorized Official Name and Position | Daniel T Harris (CFO) |
Authorized Official Contact | 2063866000 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 84026 Seattle WA 98124-8426 Ph: (425) 673-3374 | 21601 76th Ave W. Edmonds WA 98026-2100 Ph: (425) 640-4000 |
NPI Number | 1053626465 |
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Provider Enumeration Date | 08/10/2010 |
Last Update Date | 09/07/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1053626465 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
273R00000X | Psychiatric Unit | (* (Not Available)) | Secondary |
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