Individual
DAVID R PENNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
21907 64TH AVE W, SUITE 220, MOUNTLAKE TERRACE, WA 98043-6200
(425) 640-9777
(425) 640-5122
Mailing address
PO BOX 60014, SEATTLE, WA 98160-0014
(425) 640-9777
(425) 640-5122
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY00000896
WA
Other
Enumeration date
03/18/2007
Last updated
08/02/2013
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