Individual
MR. ROSS LOWELL MAYBERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1402 10TH PL N, EDMONDS, WA 98020-2629
(206) 735-9592
(206) 323-7324
Mailing address
1402 10TH PL N, EDMONDS, WA 98020-2629
(206) 735-9592
(206) 323-7324
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
WAPSY1297
WA
103TC1900X
Counseling Psychologist
PSY 1297
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
91-1985428
TAX ID #
—
Enumeration date
11/15/2006
Last updated
01/25/2024
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