# MODERN PSYCHIATRY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bellevue Psychiatry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720972961
- **Authorized official:** DR. MIGUEL DE LA MORA DNP (OWNER)
- **Authorized official phone:** (509) 910-4559

## Contact information

- **Practice address:** 1030 N CENTER PKWY STE 113, KENNEWICK, WA 99336-7160
- **Practice address phone:** (509) 910-4559
- **Practice address fax:** (509) 447-7455
- **Mailing address:** 1030 N CENTER PKWY STE 113, KENNEWICK, WA 99336-7160
- **Mailing address phone:** (509) 910-4559
- **Mailing address fax:** (509) 447-7455

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 06/04/2025
- **Last updated:** 07/22/2026