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Individual

MICHELE BEDARD-GILLIGAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
4225 ROOSEVELT WAY NE, SEATTLE, WA 98105-6099
(206) 598-7364
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 543-6420

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
60151862
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1467748004
WA
Enumeration date
06/22/2011
Last updated
12/04/2012
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