WASHINGTON STATE PSYCHOLOGICAL SERVICES, LLC


Address: 5105 200th St Sw Ste 100, Lynnwood, WA 98036-6397
Phone: 4253876972

WASHINGTON STATE PSYCHOLOGICAL SERVICES, LLC (NPI# 1801130976) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1801130976
Entity Type Organization
Organization Name WASHINGTON STATE PSYCHOLOGICAL SERVICES, LLC
Practice Address 5105 200th St Sw Ste 100
Lynnwood
WA 98036-6397
Mailing Address 3224 75th Dr Ne
Marysville
WA 98270-6804
Practice Telephone 4253876972
Practice Fax Number 4253770701
Mailing Telephone 4253876972
Enumeration Date 2012-11-15
Last Update Date 2012-11-15
Authorized Official Name DR. BRENDA HAVELLANA (NEUROPSYCHOLOGIST)
Authorized Official Telephone 4253876972
Authorized Official Credential PHD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TR0400X Psychologist
Specialization: Rehabilitation
PY60014648 WA Behavioral Health & Social Service Providers

Other Data Sources

Entity Type Entity Name Entity Address
Washington State Corporations WASHINGTON STATE PSYCHOLOGICAL SERVICES, LLC 3224 75th Dr Ne, Marysville, WA 98270-6804

Office Location

Street Address 5105 200TH ST SW STE 100
City LYNNWOOD
State WA
Zip Code 98036-6397

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1396342630 Zachary Perry Behavior Technician 4100 Veterans Way, Unit 100, Lynnwood, WA 98036 2020-10-08
1942832795 Alexis Michelle Solomon-winne Behavior Technician 4100 Veterans Way Unit 100 Lynnwood, Wa 98036 United S, Lynnwood, WA 98036 2020-02-10
1881239028 Endc Pllc Psychologist 19217 36th Ave W. Suite 219, Lynnwood, WA 98036 2019-11-12
1225507866 Kyung Suk Seo Massage Therapist 18904 Hwy 99, Ste. K, Lynnwood, WA 98036 2018-11-13
1790270197 Kabal Sriviboon Behavior Technician 20818 44th Ave W Suite 270, Lynnwood, WA 98036 2018-06-27
1992206148 Kendal Ilyse Borison Behavioral Analyst 4100 194th Se, Suite 100, Lynnwood, WA 98036 2018-02-23
1205352515 Doug Brant Registered Nurse 19931 Cypress Way, Lynnwood, WA 98036 2017-08-17
1588184980 Evergreen Recovery Centers-lynnwood Detox Substance Abuse Rehabilitation Facility 20508 56th Ave W, Lynnwood, WA 98036 2017-06-27
1699213439 Patrick J. Pacyga Dentist 19620 Wa-99, Suite 106, Lynnwood, WA 98036 2017-02-01
1134676646 Fiona Green Occupational Therapy Assistant 21503 8th Place W, A, Lynnwood, WA 98036 2016-09-01
Find all providers in zip 98036

Taxonomy Information

Taxonomy Code 103TR0400X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Rehabilitation

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1831207943 Meredith Jan Tackett Psychologist 1660 S Columbian Way # 128, Vapshcs Spinal Cord Injury Service, Seattle, WA 98108-1532 2006-08-28
1841804333 David Henry Psychologist 9330 59th Ave Sw, Lakewood, WA 98499-2858 2020-09-02
1194245308 Amy Jo Starosta Psychologist 325 9th Ave, Seattle, WA 98104-2420 2017-06-20
1508238924 Rebecca Stafford Psychologist 8282 28th Ct Ne Ste A, Lacey, WA 98516-7162 2015-10-25
1689094294 Michelle C. Accardi-ravid Psychologist 325 9th Ave, Seattle, WA 98104-2420 2014-04-22
1962655399 Elizabeth Kunchandy Psychologist 1660 S Columbian Way, Rehabilitation Care Service, S-117-rcs Va Puget Sound, Seattle, WA 98108-1532 2008-10-29
1063521847 Randi Lincoln Psychologist 1660 S Columbian Way, Seattle, WA 98108-1532 2006-08-29
1881685683 Joy Rebecca White Martinez Psychologist 711 S Cowley St, Spokane, WA 99202-1330 2005-10-31

Competitor

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City LYNNWOOD
Zip Code 98036

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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