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Individual

DIANE M SCOVILLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD, LICSW

Contact information

Practice address
4026 NE 55TH ST STE C, SEATTLE, WA 98105-2254
(206) 227-1220
Mailing address
4026 NE 55TH ST STE C, SEATTLE, WA 98105-2254
(206) 227-1220

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY00003677
WA
1041C0700X
Clinical Social Worker
LW00005608
WA

Other

Enumeration date
06/25/2007
Last updated
01/27/2021
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