# DOMAIN PSYCHIATRY, PLLC

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

## Provider details

- **NPI number:** 1902779796
- **Authorized official:** MATTHEW CLARK (OWNER)
- **Authorized official phone:** (206) 208-8957

## Contact information

- **Practice address:** 819 N 49TH ST STE 302, SEATTLE, WA 98103-6577
- **Practice address phone:** (206) 208-8957
- **Mailing address:** PO BOX 257, PMB 11130, OLYMPIA, WA 98507-0257
- **Mailing address phone:** (206) 208-8957

## 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:** 09/26/2025
- **Last updated:** 09/26/2025