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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103TR0400X |
Psychologist Specialization: Rehabilitation |
PY60014648 | WA | Behavioral Health & Social Service Providers |
Entity Type | Entity Name | Entity Address |
---|---|---|
Washington State Corporations | WASHINGTON STATE PSYCHOLOGICAL SERVICES, LLC | 3224 75th Dr Ne, Marysville, WA 98270-6804 |
Street Address |
5105 200TH ST SW STE 100 |
City | LYNNWOOD |
State | WA |
Zip Code | 98036-6397 |
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 Code | 103TR0400X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Rehabilitation |
Definition to come... |
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 |
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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.