Individual
VIVIEN JOHNETTE PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
195 NE GILMAN BLVD, SUITE 202, ISSAQUAH, WA 98027-2940
(425) 391-8611
Mailing address
26332 135TH AVE SE, KENT, WA 98042-3518
(253) 630-8118
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1265
WA
Other
Enumeration date
01/03/2007
Last updated
07/08/2007
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