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1455 Nw Leary Way Ste 400 Seattle WA 98107-5138 | |
| (818) 446-2522 | |
| (818) 284-6368 |
| Full Name | |
|---|---|
| Speciality | Psychologist |
| Location | 1455 Nw Leary Way Ste 400, Seattle, Washington |
| Authorized Official Name and Position | Narineh Hartoonian (CEO) |
| Authorized Official Contact | 8185464339 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
500 E Olive Ave Ste 540 Burbank CA 91501-2132 Ph: (818) 446-2238 | 1455 Nw Leary Way Ste 400 Seattle WA 98107-5138 Ph: (818) 446-2522 |
| NPI Number | 1285411884 |
|---|---|
| Provider Enumeration Date | 09/08/2023 |
| Last Update Date | 07/02/2024 |
| Certification Date | 07/02/2024 |
| Medicare PECOS PAC ID | 7911227509 |
|---|---|
| Medicare Enrollment ID | O20231018002259 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285411884 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Katrina B Kwan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760727580 PECOS PAC ID: 1052565728 Enrollment ID: I20211216001020 |
| Provider Name | Meredith Jan Tackett |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1831207943 PECOS PAC ID: 3678929189 Enrollment ID: I20231019001386 |
| Provider Name | Teresa Hastings |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1871817841 PECOS PAC ID: 2062549942 Enrollment ID: I20240514000080 |
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