| Washington State Psychological Services, Llc | |
|
5105 200th St Sw Ste 100 Lynnwood WA 98036-6397 | |
| (425) 387-6972 | |
| (425) 377-0701 |
| Full Name | Washington State Psychological Services, Llc |
|---|---|
| Speciality | Psychologist - Rehabilitation |
| Location | 5105 200th St Sw Ste 100, Lynnwood, Washington |
| Authorized Official Name and Position | Brenda Havellana (NEUROPSYCHOLOGIST) |
| Authorized Official Contact | 4253876972 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Washington State Psychological Services, Llc 3224 75th Dr Ne Marysville WA 98270-6804 Ph: (425) 387-6972 | Washington State Psychological Services, Llc 5105 200th St Sw Ste 100 Lynnwood WA 98036-6397 Ph: (425) 387-6972 |
| NPI Number | 1801130976 |
|---|---|
| Provider Enumeration Date | 11/15/2012 |
| Last Update Date | 11/15/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801130976 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TR0400X | Psychologist - Rehabilitation | PY60014648 (Washington) | Primary |
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