Organization
WASHINGTON STATE PSYCHOLOGICAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENDA HAVELLANA PHD (NEUROPSYCHOLOGIST)
(425) 387-6972
Entity
Organization
Contact information
Practice address
5105 200TH ST SW STE 100, LYNNWOOD, WA 98036-6397
(425) 387-6972
(425) 377-0701
Mailing address
3224 75TH DR NE, MARYSVILLE, WA 98270-6804
(425) 387-6972
Taxonomy
Speciality
Code
Description
License number
State
103TR0400X
Rehabilitation Psychologist
Primary
PY60014648
WA
Other
Enumeration date
11/15/2012
Last updated
11/15/2012
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