Individual
MS. SALLY DEANE BLISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D
Contact information
Practice address
1740 NW MAPLE ST, STE. 210, ISSAQUAH, WA 98027-8127
(425) 625-6874
(425) 427-2477
Mailing address
1740 NW MAPLE ST, STE. 210, ISSAQUAH, WA 98027-8127
(425) 625-6874
(425) 427-2477
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PY 00002266
WA
103TB0200X
Cognitive & Behavioral Psychologist
PY 00002266
WA
103TC0700X
Clinical Psychologist
Primary
PY 00002266
WA
103TC1900X
Counseling Psychologist
PY 00002266
WA
103TF0000X
Family Psychologist
PY 00002266
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PY 00002266
PSYCHOLOGIST LICENSE
WA
Enumeration date
02/01/2007
Last updated
03/13/2017
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