| Edward L Coyle Ph.d. Pllc | |
|
4007 Bridgeport Way W Ste A University Place WA 98466-4330 | |
| (201) 201-3215 | |
| (253) 302-6412 |
| Full Name | Edward L Coyle Ph.d. Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4007 Bridgeport Way W Ste A, University Place, Washington |
| Authorized Official Name and Position | Edward L Coyle (CEO) |
| Authorized Official Contact | 4052297762 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Edward L Coyle Ph.d. Pllc 4007 Bridgeport Way W Ste A University Place WA 98466-4330 Ph: (201) 201-3215 | Edward L Coyle Ph.d. Pllc 4007 Bridgeport Way W Ste A University Place WA 98466-4330 Ph: (201) 201-3215 |
| NPI Number | 1992428726 |
|---|---|
| Provider Enumeration Date | 09/26/2022 |
| Last Update Date | 09/26/2022 |
| Certification Date | 09/26/2022 |
| Medicare PECOS PAC ID | 4183094360 |
|---|---|
| Medicare Enrollment ID | O20230104001509 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992428726 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Edward Louis Coyle |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1982651709 PECOS PAC ID: 5092185272 Enrollment ID: I20230104001563 |
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