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Individual

DR. ANNE COUGHLIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
16856 NE 14TH PL, BELLEVUE, WA 98008-2802
(425) 417-7242
Mailing address
16856 NE 14TH PL, BELLEVUE, WA 98008-2802
(425) 417-7242

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
PSY10438
CA
103TC0700X
Clinical Psychologist
Primary
PY00001942
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PSY10438
CA PSYCH LICENSE INACTIVE
CA
Enumeration date
06/17/2007
Last updated
09/08/2009
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