Provider Demographics
NPI:1245563832
Name:DIAMOND, TOBY (PHD)
Entity Type:Individual
Prefix:DR
First Name:TOBY
Middle Name:
Last Name:DIAMOND
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 FAIRVIEW AVE. EAST
Mailing Address - Street 2:HOUSEBOAT #6
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-3154
Mailing Address - Country:US
Mailing Address - Phone:206-323-1988
Mailing Address - Fax:
Practice Address - Street 1:2727 FAIRVIEW AVE. E.
Practice Address - Street 2:HOUSEBOAT #6
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-3154
Practice Address - Country:US
Practice Address - Phone:206-323-1988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-14
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PY00000959103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist