Organization
PREMIER THERAPEUTIC EXPERIENCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON E. STOGSDILL LMHC, CDPT (CLINICIAN)
(253) 970-0779
Entity
Organization
Contact information
Practice address
8105 166TH AVE NE, SUITE 202, REDMOND, WA 98052-3999
(253) 970-0779
Mailing address
8105 166TH AVE NE, SUITE 202, REDMOND, WA 98052-3999
(253) 970-0779
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
CO 60180142
WA
305R00000X
Preferred Provider Organization
Primary
LH 60270904
WA
Other
Enumeration date
05/07/2012
Last updated
05/07/2012
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