Organization
WESTERN WASHINGTON MEDICAL GROUP, INC PS
Active
Parent organization
WESTERN WASHINGTON MEDICAL GROUP
Other names
Western Wa Medical Group Dept of Psychology
Organization subpart
Yes
Provider details
NPI number
Legal business name
WESTERN WASHINGTON MEDICAL GROUP
Authorized official
MS. VICKI MCGINNIS (PRIVACY OFFICER)
(425) 259-4041
Entity
Organization
Contact information
Practice address
3525 COLBY AVE STE 200, EVERETT, WA 98201-4782
(425) 259-1366
(425) 252-4778
Mailing address
3525 COLBY AVE STE 200, EVERETT, WA 98201-4782
(425) 259-1366
(425) 252-4778
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
601474013
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0202207
LABOR & INDUSTRY
WA
Enumeration date
04/23/2007
Last updated
08/25/2016
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