| Insight Psychology | |
|
409 E Sumach St Ste 3 Walla Walla WA 99362-1202 | |
| (509) 876-1793 | |
| Not Available |
| Full Name | Insight Psychology |
|---|---|
| Speciality | Psychologist |
| Location | 409 E Sumach St Ste 3, Walla Walla, Washington |
| Authorized Official Name and Position | Pavel Blagov (PSYCHOLOGIST) |
| Authorized Official Contact | 5098761793 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Insight Psychology 885 Hedine Rd Walla Walla WA 99362-8716 Ph: (509) 876-1793 | Insight Psychology 409 E Sumach St Ste 3 Walla Walla WA 99362-1202 Ph: (509) 876-1793 |
| NPI Number | 1558863993 |
|---|---|
| Provider Enumeration Date | 03/01/2018 |
| Last Update Date | 09/22/2018 |
| Medicare PECOS PAC ID | 0143585018 |
|---|---|
| Medicare Enrollment ID | O20180523002203 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558863993 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY60236271 (Washington) | Primary |
| Provider Name | Pavel S Blagov |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1346515541 PECOS PAC ID: 7911154356 Enrollment ID: I20120820001184 |
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