| Intellect Psychiatry Services Pllc | |
|
6505 216th St Sw Ste 100 Mountlake Terrace WA 98043-2089 | |
| (469) 321-9543 | |
| (682) 227-2030 |
| Full Name | Intellect Psychiatry Services Pllc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 6505 216th St Sw Ste 100, Mountlake Terrace, Washington |
| Authorized Official Name and Position | Etienne Clement Poufong (PMHNP) |
| Authorized Official Contact | 4693219543 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Intellect Psychiatry Services Pllc 708 Clement Dr Cedar Hill TX 75104-7352 Ph: (469) 321-9543 | Intellect Psychiatry Services Pllc 6505 216th St Sw Ste 100 Mountlake Terrace WA 98043-2089 Ph: (469) 321-9543 |
| NPI Number | 1669195202 |
|---|---|
| Provider Enumeration Date | 09/20/2022 |
| Last Update Date | 07/31/2023 |
| Certification Date | 07/31/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669195202 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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