Individual
DR. MARY A. MCGONIGLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
2366 EASTLAKE AVE E STE 439, SEATTLE, WA 98102-3392
(206) 323-7742
Mailing address
2366 EASTLAKE AVE E STE 439, SEATTLE, WA 98102-3392
(206) 323-7742
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY1922
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20-4956959
TAX IDENTIFICATION NUMBER
—
01
—
PY1922
PSYCHOLOGIST-STATE OF WA
—
Enumeration date
03/19/2007
Last updated
09/24/2021
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