| Psychiatry Northwest, Llc | |
|
2150 N 107th St Ste 400 Seattle WA 98133-9009 | |
| (206) 402-3375 | |
| Not Available |
| Full Name | Psychiatry Northwest, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2150 N 107th St Ste 400, Seattle, Washington |
| Authorized Official Name and Position | Jesse Mcclelland (OWNER) |
| Authorized Official Contact | 2064023375 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychiatry Northwest, Llc 2366 Eastlake Ave E Ste 428 Seattle WA 98102-3392 Ph: (206) 402-3375 | Psychiatry Northwest, Llc 2150 N 107th St Ste 400 Seattle WA 98133-9009 Ph: (206) 402-3375 |
| NPI Number | 1578925921 |
|---|---|
| Provider Enumeration Date | 03/24/2016 |
| Last Update Date | 07/28/2022 |
| Certification Date | 07/28/2022 |
| Medicare PECOS PAC ID | 3476881335 |
|---|---|
| Medicare Enrollment ID | O20190830000058 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578925921 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | MD60133295 (Washington) | Primary |
| Provider Name | Jesse P Mcclelland |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033395587 PECOS PAC ID: 2769678192 Enrollment ID: I20101126000020 |
| Provider Name | Michael A Brooks |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356570550 PECOS PAC ID: 8426367152 Enrollment ID: I20160505000453 |
| Provider Name | Arvinder Kaul |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396792578 PECOS PAC ID: 4486680121 Enrollment ID: I20180615001143 |
| Provider Name | Abby Rose Mcclelland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902358583 PECOS PAC ID: 5294063152 Enrollment ID: I20190904003139 |
| Provider Name | Bonnie Culbertson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780107003 PECOS PAC ID: 8426318619 Enrollment ID: I20230509001668 |
| Provider Name | Kristine Lynn Holland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649951195 PECOS PAC ID: 5395191415 Enrollment ID: I20231026000670 |
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