Organization
NORTHWEST PSYCHIATRIC ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE JACKSON ULLRICH MD (PRESIDENT)
(208) 765-0955
Entity
Organization
Contact information
Practice address
1115 IRONWOOD DRIVE, COEUR D ALENE, ID 83814-4936
(208) 765-0955
(208) 765-6972
Mailing address
PO BOX 1356, COEUR D ALENE, ID 83816-1356
(208) 765-0955
(208) 765-6972
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
10/31/2006
Last updated
08/22/2020
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