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13128 Totem Lake Blvd Ne Ste 104 Kirkland WA 98034-2953 | |
| (425) 202-7748 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 13128 Totem Lake Blvd Ne Ste 104, Kirkland, Washington |
| Authorized Official Name and Position | Leslie R Fuchs (ADMIN CEO) |
| Authorized Official Contact | 8103581643 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
11000 Optum Cir Eden Prairie MN 55344-2503 Ph: (877) 299-5426 | 13128 Totem Lake Blvd Ne Ste 104 Kirkland WA 98034-2953 Ph: (425) 202-7748 |
| NPI Number | 1629812409 |
|---|---|
| Provider Enumeration Date | 06/25/2024 |
| Last Update Date | 08/21/2024 |
| Certification Date | 08/21/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629812409 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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