Provider Demographics
NPI:1093473704
Name:CHILD AND ADOLESCENT PSYCHOLOGICAL SERVICES OF SEATTLE, PLLC
Entity Type:Organization
Organization Name:CHILD AND ADOLESCENT PSYCHOLOGICAL SERVICES OF SEATTLE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MAGGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BROMNBERG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:206-428-6102
Mailing Address - Street 1:7222 LINDEN AVE N APT A
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-5177
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7222 LINDEN AVE N APT A
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-5177
Practice Address - Country:US
Practice Address - Phone:206-428-6102
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health