| Ronald O Powell Phd Pllc | |
|
8201 164th Ave Ne Ste 200 Redmond WA 98052-7615 | |
| (425) 214-3609 | |
| Not Available |
| Full Name | Ronald O Powell Phd Pllc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 8201 164th Ave Ne Ste 200, Redmond, Washington |
| Authorized Official Name and Position | Roald O Powell (OWNER) |
| Authorized Official Contact | 4252143609 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ronald O Powell Phd Pllc 8201 164th Ave Ne Ste 200 Redmond WA 98052-7615 Ph: (425) 214-3609 | Ronald O Powell Phd Pllc 8201 164th Ave Ne Ste 200 Redmond WA 98052-7615 Ph: (425) 214-3609 |
| NPI Number | 1275923534 |
|---|---|
| Provider Enumeration Date | 01/26/2015 |
| Last Update Date | 03/17/2015 |
| Medicare PECOS PAC ID | 3779802046 |
|---|---|
| Medicare Enrollment ID | O20150507002712 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275923534 | NPI | - | NPPES |
| 1275923534 | Other | WA | NATIONAL PLAN AND PROVIDER ENUMERATION |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | PY00001122 (Washington) | Primary |
| Provider Name | Ronald O Powell |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1083767495 PECOS PAC ID: 0143284315 Enrollment ID: I20041117000426 |
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