# AGATE PASSAGE PSYCHOLOGICAL SERVICES, INC. PS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760522627
- **Authorized official:** DR. SUZANNE BACHMAN IVEY PH.D. (PRESIDENT)
- **Authorized official phone:** (206) 842-9949

## Contact information

- **Practice address:** 785 ERICKSEN AVE NE, SUITE 117, BAINBRIDGE ISLAND, WA 98110-1875
- **Practice address phone:** (206) 842-9949
- **Practice address fax:** (360) 697-1079
- **Mailing address:** 785 ERICKSEN AVE NE, SUITE 117, BAINBRIDGE ISLAND, WA 98110-1875
- **Mailing address phone:** (206) 842-9949
- **Mailing address fax:** (360) 697-1079

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103T00000X | Psychologist | PSY00001604 | WA | Yes |

## Other

- **Enumeration date:** 02/08/2007
- **Last updated:** 08/22/2020