Individual
DR. WILLIAM JOHN CHALSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH D
Contact information
Practice address
2501 MILE HILL DRIVE, SUITE A 105 PORT ORCHARD CLINICAL PSYCHOLOGY CENTER, PORT ORCHARD, WA 98366-0776
(360) 876-0285
(360) 876-4685
Mailing address
PO BOX 776, PORT ORCHARD, WA 98366-0776
(360) 876-0285
(360) 876-4685
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY00001242
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
137334
MANGED HEALTH NETWORK
—
01
—
37794
DEPT OF LABOR & INDUSTRIE
WA
05
—
7046725
—
WA
Enumeration date
10/05/2006
Last updated
07/08/2007
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