Individual
DR. CORY DAVID SECRIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1417 NW 54TH ST STE 372, SEATTLE, WA 98107-3575
(206) 788-7579
Mailing address
16731 8TH AVE NE, SHORELINE, WA 98155-5013
(206) 788-7579
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY60588923
WA
Other
Enumeration date
07/19/2017
Last updated
04/03/2018
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