Provider Demographics
NPI:1265650972
Name:CHILD PSYCHOLOGY NORTHWEST, P.S.
Entity Type:Organization
Organization Name:CHILD PSYCHOLOGY NORTHWEST, P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & CLINICAL NEUROPSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:206-364-6565
Mailing Address - Street 1:2150 N 107TH ST
Mailing Address - Street 2:SUITE 345, NORTHWAY EAST BUILDING
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-1305
Mailing Address - Country:US
Mailing Address - Phone:206-364-6565
Mailing Address - Fax:206-364-6566
Practice Address - Street 1:2150 N 107TH ST
Practice Address - Street 2:SUITE 345, NORTHWAY EAST BUILDING
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-1305
Practice Address - Country:US
Practice Address - Phone:206-364-6565
Practice Address - Fax:206-364-6566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA103G00000X, 103TB0200X, 103TC0700X, 103TC2200X, 103TF0200X, 103TH0100X, 103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
Not Answered103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
Not Answered103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensicGroup - Multi-Specialty
Not Answered103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth ServiceGroup - Multi-Specialty
Not Answered103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Multi-Specialty