Provider Demographics
NPI:1073642492
Name:MCDERMOTT, LOIS J (PHD)
Entity Type:Individual
Prefix:DR
First Name:LOIS
Middle Name:J
Last Name:MCDERMOTT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:LOIS
Other - Middle Name:J
Other - Last Name:MCDERMOTT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:4026 NE 55TH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-2262
Mailing Address - Country:US
Mailing Address - Phone:206-522-6590
Mailing Address - Fax:206-528-5675
Practice Address - Street 1:4026 NE 55TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-2262
Practice Address - Country:US
Practice Address - Phone:206-522-6590
Practice Address - Fax:206-528-5675
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00001387103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist