Provider Demographics
NPI:1174634570
Name:WESLEY, MARCIA ADAMS (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MARCIA
Middle Name:ADAMS
Last Name:WESLEY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16770 NE 79TH ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-4413
Mailing Address - Country:US
Mailing Address - Phone:425-882-0127
Mailing Address - Fax:425-788-8205
Practice Address - Street 1:16770 NE 79TH ST
Practice Address - Street 2:SUITE 203
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-4413
Practice Address - Country:US
Practice Address - Phone:425-882-0127
Practice Address - Fax:425-788-8205
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALIC.PSY. 2995103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist