Organization
ISLAND BEHAVIORAL MEDICINE, PS
Active
Other names
Island Behavioral Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PAULA LOUISE CASEY L.M.F.T. (OWNER)
(360) 682-5016
Entity
Organization
Contact information
Practice address
3208 K AVE, ANACORTES, WA 98221
(360) 682-5016
Mailing address
PO BOX 378, ANACORTES, WA 98221-0378
(360) 682-5016
(360) 682-5476
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LH60428818
WA
103T00000X
Psychologist
PY60620631
WA
1041C0700X
Clinical Social Worker
LW60395422
WA
106H00000X
Marriage & Family Therapist
Primary
LF60125307
WA
2084P0800X
Psychiatry Physician
OP60248624
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2044886
—
WA
01
—
G8957249
MEDICARE PTAN
WA
Enumeration date
05/18/2015
Last updated
07/31/2018
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