| Other Name | |
|
3245 Fairview Ave E Ste 310 Seattle WA 98102 | |
| (206) 324-3581 | |
| (866) 602-1865 |
| Full Name | Other Name |
|---|---|
| Speciality | Psychologist |
| Location | 3245 Fairview Ave E Ste 310, Seattle, Washington |
| Authorized Official Name and Position | Peggy S Wood (OWNER/PSYCHOLOGIST) |
| Authorized Official Contact | 2063243581 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Other Name 3245 Fairview Ave E Ste 310 Seattle WA 98102-3053 Ph: (206) 324-3581 | Other Name 3245 Fairview Ave E Ste 310 Seattle WA 98102 Ph: (206) 324-3581 |
| NPI Number | 1801380191 |
|---|---|
| Provider Enumeration Date | 06/19/2018 |
| Last Update Date | 06/22/2018 |
| Medicare PECOS PAC ID | 6709132418 |
|---|---|
| Medicare Enrollment ID | O20180711001975 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801380191 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | 1785 (Washington) | Primary |
| Provider Name | Peggy S Wood |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1649238502 PECOS PAC ID: 0143284273 Enrollment ID: I20041117000938 |
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