Provider Demographics
NPI:1124563945
Name:TELFORD, ROY SCOTT
Entity Type:Individual
Prefix:
First Name:ROY
Middle Name:SCOTT
Last Name:TELFORD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1240 116TH AVE NE
Mailing Address - Street 2:UNIT 102
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3815
Mailing Address - Country:US
Mailing Address - Phone:206-437-5412
Mailing Address - Fax:
Practice Address - Street 1:1240 116TH AVE NE
Practice Address - Street 2:UNIT 102
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3815
Practice Address - Country:US
Practice Address - Phone:206-437-5412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-03
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst