Provider Demographics
NPI:1275502650
Name:FINCH, INDRA A (PHD)
Entity Type:Individual
Prefix:DR
First Name:INDRA
Middle Name:A
Last Name:FINCH
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 1:6108 COMMUNITY PL SW
Mailing Address - Street 2:SUITE 3
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-2447
Mailing Address - Country:US
Mailing Address - Phone:253-581-1423
Mailing Address - Fax:253-581-1425
Practice Address - Street 1:6108 COMMUNITY PL SW
Practice Address - Street 2:SUITE 3
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-2447
Practice Address - Country:US
Practice Address - Phone:253-581-1423
Practice Address - Fax:253-581-1425
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-16
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00001849103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB08239Medicare PIN
WAS13254Medicare UPIN