Individual
MARYELLEN DOUGHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13620 NE 20TH ST STE I, BELLEVUE, WA 98005-4901
(425) 647-7695
Mailing address
13620 NE 20TH ST STE I, BELLEVUE, WA 98005-4901
(425) 647-7695
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY60664588
WA
103T00000X
Psychologist
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—
Other
Enumeration date
09/17/2014
Last updated
08/07/2023
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