Provider Demographics
NPI:1073766390
Name:WATSON, PAIGE MAUREEN (MS)
Entity Type:Individual
Prefix:MRS
First Name:PAIGE
Middle Name:MAUREEN
Last Name:WATSON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MRS
Other - First Name:PAIGE
Other - Middle Name:MAUREEN
Other - Last Name:WATSON SCHORNACK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS
Mailing Address - Street 1:1133 RAILROAD AVE
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-5055
Mailing Address - Country:US
Mailing Address - Phone:360-676-2164
Mailing Address - Fax:360-676-2144
Practice Address - Street 1:320 PACIFIC PL
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-5463
Practice Address - Country:US
Practice Address - Phone:360-416-7546
Practice Address - Fax:360-416-7541
Is Sole Proprietor?:No
Enumeration Date:2008-10-30
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health