| Pax Psychotherapy Pllc | |
|
1127 10th Ave E Ste 5 Seattle WA 98102-4377 | |
| (206) 309-7915 | |
| Not Available |
| Full Name | Pax Psychotherapy Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 1127 10th Ave E Ste 5, Seattle, Washington |
| Authorized Official Name and Position | Ann Carter (OWNER) |
| Authorized Official Contact | 2063097915 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pax Psychotherapy Pllc 2722 Eastlake Ave E Ste 300 Seattle WA 98102-3143 Ph: () - | Pax Psychotherapy Pllc 1127 10th Ave E Ste 5 Seattle WA 98102-4377 Ph: (206) 309-7915 |
| NPI Number | 1508440835 |
|---|---|
| Provider Enumeration Date | 05/12/2021 |
| Last Update Date | 11/09/2022 |
| Certification Date | 11/09/2022 |
| Medicare PECOS PAC ID | 7618371642 |
|---|---|
| Medicare Enrollment ID | O20210812000947 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508440835 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Ann L Carter |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1083167647 PECOS PAC ID: 2163709767 Enrollment ID: I20170509001835 |
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