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Individual

DR. MARTHA LOUISE GLISKY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
1808 RICHARDS RD, SUITE 120, BELLEVUE, WA 98005-3982
(425) 677-7476
(425) 677-7476
Mailing address
1808 RICHARDS RD, SUITE 120, BELLEVUE, WA 98005-3982
(425) 677-7476
(425) 677-7476

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PY00002466
WA
103TC0700X
Clinical Psychologist
PY00002466
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8382822
WA
Enumeration date
11/30/2006
Last updated
01/26/2017
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