Provider Demographics
NPI:1003079856
Name:NW MEDICAL PSYCHOLOGY, INC. PS
Entity Type:Organization
Organization Name:NW MEDICAL PSYCHOLOGY, INC. PS
Other - Org Name:NORTHWEST MEDICAL PSYCHOLOGY
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:C
Authorized Official - Last Name:STEGER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:360-734-4046
Mailing Address - Street 1:3120 SQUALICUM PKWY
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1934
Mailing Address - Country:US
Mailing Address - Phone:360-734-4046
Mailing Address - Fax:360-734-6727
Practice Address - Street 1:3120 SQUALICUM PKWY
Practice Address - Street 2:SUITE 2
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1934
Practice Address - Country:US
Practice Address - Phone:360-734-4046
Practice Address - Fax:360-734-6727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-02
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00000512103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty