Provider Demographics
NPI:1205008356
Name:MARIE L SWEENEY PHD INC.
Entity Type:Organization
Organization Name:MARIE L SWEENEY PHD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:SWEENEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD,
Authorized Official - Phone:425-761-6036
Mailing Address - Street 1:PO BOX 52706
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98015-2706
Mailing Address - Country:US
Mailing Address - Phone:425-761-6036
Mailing Address - Fax:
Practice Address - Street 1:1601 116TH AVE NE
Practice Address - Street 2:STE. 102
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3010
Practice Address - Country:US
Practice Address - Phone:425-761-6036
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-28
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2446103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB38894Medicare UPIN
WAAB38895Medicare UPIN