Organization
PUGET SOUND PSYCHIATRIC CENTER, PS
Active
Organization
PUGET SOUND PSYCHIATRIC CENTER, PS
Active
Other names
PSPC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SYED JAMAL MUSTAFA MD (MEDICAL DIRECTOR)
(425) 806-5021
Entity
Organization
Contact information
Practice address
10634 E RIVERSIDE DR, SUITE 130, BOTHELL, WA 98011-3757
(425) 806-5021
(425) 486-3949
Mailing address
10634 E RIVERSIDE DR, SUITE 130, BOTHELL, WA 98011-3758
(425) 806-5021
(425) 486-3949
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
2084P0800X
Psychiatry Physician
Primary
MD00034219
WA
2084P0800X
Psychiatry Physician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
363A00000X
Physician Assistant
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1112333
—
WA
Enumeration date
11/03/2009
Last updated
01/23/2012
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