Organization
PUGET SOUND SENIOR PSYCHOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID AGNOR PHD (EXECUTIVE DIRECTOR)
(360) 253-4912
Entity
Organization
Contact information
Practice address
9340 NE 76TH ST, VANCOUVER, WA 98662-3721
(360) 253-4912
(360) 253-5170
Mailing address
9340 NE 76TH ST, VANCOUVER, WA 98662-3721
(360) 253-4912
(360) 253-5170
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
PY1511
WA
Other
Enumeration date
06/02/2016
Last updated
06/02/2016
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