is a Psychiatry in Kirkland, Washington. practices all healthcare services and medical treatments related to Psychiatry. The NPI Number for is 1104036631. The last update date is .
's current location address is 12025 115th Ave Ne, Building D, Ste 200, Kirkland, Washington. You can contact this provider via phone number 4258211810 and fax number 4258231231. The mailing address for is 12025 115th Ave Ne, Building D, Ste 200, Kirkland, Washington. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 12025 115th Ave Ne, Building D, Ste 200, Kirkland, Washington |
| Phone Number | 4258211810 |
| Fax Number | 4258231231 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1104036631 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 12025 115th Ave Ne, Building D, Ste 200 |
|---|---|
| City | Kirkland |
| State | Washington (WA) |
| Post Code | 980342831 |
| Phone Number | 4258211810 |
| Fax Number | 4258231231 |
Provider's Primary Taxonomy Detail
| Speciality | Psychiatry |
|---|---|
| Taxonomy | 2084P0800X |
| Licence No | 53335-20 |
|
Definition: A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 53335-20 | WI | WISCONSIN STATE LICENSE | |
| MD60240047 | WA | WA STATE LICENSE |
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