| Tacoma Psychology, Pllc | |
|
1919 N Pearl St Ste C2 Tacoma WA 98406-2490 | |
| (253) 383-0101 | |
| (253) 383-0149 |
| Full Name | Tacoma Psychology, Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 1919 N Pearl St Ste C2, Tacoma, Washington |
| Authorized Official Name and Position | Brad L Bates (OWNER) |
| Authorized Official Contact | 2533830101 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tacoma Psychology, Pllc 1919 N Pearl St Ste C2 Tacoma WA 98406-2490 Ph: (253) 383-0101 | Tacoma Psychology, Pllc 1919 N Pearl St Ste C2 Tacoma WA 98406-2490 Ph: (253) 383-0101 |
| NPI Number | 1568422277 |
|---|---|
| Provider Enumeration Date | 03/25/2006 |
| Last Update Date | 04/06/2023 |
| Certification Date | 04/06/2023 |
| Medicare PECOS PAC ID | 0244240232 |
|---|---|
| Medicare Enrollment ID | O20060504000871 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568422277 | NPI | - | NPPES |
| 0207038 | Other | WA | DEPT OF LABOR & INDUSTRIE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 1546 (Washington) | Primary |
| Provider Name | Brad L Bates |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1346388295 PECOS PAC ID: 1951311943 Enrollment ID: I20060505000521 |
| Provider Name | John Ernst |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063624104 PECOS PAC ID: 7911093596 Enrollment ID: I20071011000660 |
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