Provider Demographics
NPI:1225322027
Name:FLORES, SERGIO (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SERGIO
Middle Name:
Last Name:FLORES
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7121 27TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98106-1755
Mailing Address - Country:US
Mailing Address - Phone:949-500-4638
Mailing Address - Fax:
Practice Address - Street 1:200 W MERCER ST STE 111
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98119-3958
Practice Address - Country:US
Practice Address - Phone:949-500-4638
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-09
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY60545566103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist