Individual
TY W LOSTUTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
4225 ROOSEVELT WAY NE, SEATTLE, WA 98105-6099
(206) 598-7792
Mailing address
4225 ROOSEVELT WAY NE, SEATTLE, WA 98105-6099
(206) 598-7792
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY 60238397
WA
Other
Enumeration date
04/29/2014
Last updated
04/29/2014
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