Provider Demographics
NPI:1043435019
Name:DE LANCEY, ANN L (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:L
Last Name:DE LANCEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:ANN
Other - Middle Name:L
Other - Last Name:DE LANCEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:9125 VIEW AVE NW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98117-2654
Mailing Address - Country:US
Mailing Address - Phone:206-322-0131
Mailing Address - Fax:
Practice Address - Street 1:3121 E MADISON ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-4262
Practice Address - Country:US
Practice Address - Phone:206-322-0131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY 1691103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist