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Organization
PUGET SOUND SENIOR PSYCHOLOGY LLC
Active
Organization
PUGET SOUND SENIOR PSYCHOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID W AGNOR PHD (EXECUTIVE DIRECTOR)
(360) 253-4912
Entity
Organization
Contact information
Practice address
9340 NE 76TH ST, VANCOUVER, WA 98662-3721
(360) 253-4912
Mailing address
9340 NE 76TH ST, VANCOUVER, WA 98662-3721
(360) 253-4912
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
558
AK
314000000X
Skilled Nursing Facility
Primary
PY 60550073
WA
Other
Enumeration date
01/05/2016
Last updated
01/05/2016
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