Provider Demographics
NPI:1265684765
Name:SEEMAN, GARY (PHD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:
Last Name:SEEMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9901 NE 7TH AVE STE B231
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98685-4538
Mailing Address - Country:US
Mailing Address - Phone:415-271-2350
Mailing Address - Fax:360-887-2126
Practice Address - Street 1:9901 NE 7TH AVE STE B231
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98685-4538
Practice Address - Country:US
Practice Address - Phone:415-271-2350
Practice Address - Fax:360-887-2126
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-15
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY19356103TC0700X
WAPY60478357103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP01250487OtherRAILROAD MEDICARE PTAN
WA2136974Medicaid
CACQ016AMedicare UPIN