Organization
SILVERDALE PSYCHIATRIC SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLE HEINE LMHC (OWNER/PROVIDER)
(253) 588-7911
Entity
Organization
Contact information
Practice address
7191 WAGNER WAY NW, SUITE 301, GIG HARBOR, WA 98335-6909
(253) 514-8076
(253) 514-8078
Mailing address
PO BOX 97115, LAKEWOOD, WA 98497-0115
(253) 588-7911
(253) 984-6774
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LH00003850
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LH00003850
CAROLE'S MEDICAL LICENSE
WA
Enumeration date
07/14/2011
Last updated
07/14/2011
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