Individual
JED N MCGIFFIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1959 NE PACIFIC ST, SEATTLE, WA 98195-0001
(206) 520-5000
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 520-5700
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
PY61337524
WA
103TR0400X
Rehabilitation Psychologist
Primary
PY61337524
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1528797727
—
WA
Enumeration date
06/06/2022
Last updated
09/08/2022
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