Provider Demographics
NPI:1043411630
Name:PERRY, DAVID R (RC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:R
Last Name:PERRY
Suffix:
Gender:M
Credentials:RC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 E OLIVE ST
Mailing Address - Street 2:SOUND MENTAL HEALTH
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-2735
Mailing Address - Country:US
Mailing Address - Phone:206-302-2200
Mailing Address - Fax:206-302-2210
Practice Address - Street 1:1314 8TH ST NE
Practice Address - Street 2:SUITE 103
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-4587
Practice Address - Country:US
Practice Address - Phone:253-876-7600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00053174101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional