Provider Demographics
NPI:1275526949
Name:DEES, WAYNE C (PSYD)
Entity Type:Individual
Prefix:MR
First Name:WAYNE
Middle Name:C
Last Name:DEES
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:P.O. BOX 66397
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166
Mailing Address - Country:US
Mailing Address - Phone:206-217-4530
Mailing Address - Fax:206-217-4533
Practice Address - Street 1:14212 AMBAUM BLVD SW
Practice Address - Street 2:SUITE 103
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166
Practice Address - Country:US
Practice Address - Phone:206-217-4530
Practice Address - Fax:206-217-4533
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00052944101Y00000X
WAPY3311103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8857047Medicare PIN