Provider Demographics
NPI:1285682914
Name:CALLIES, DAVID FREDERICK (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:FREDERICK
Last Name:CALLIES
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 1:2101 4TH AVE E
Mailing Address - Street 2:SUITE 202
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-6512
Mailing Address - Country:US
Mailing Address - Phone:360-236-0206
Mailing Address - Fax:360-236-9909
Practice Address - Street 1:2101 4TH AVE E
Practice Address - Street 2:SUITE 202
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-6512
Practice Address - Country:US
Practice Address - Phone:360-236-0206
Practice Address - Fax:360-236-9909
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY0003082103TB0200X, 103TC0700X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical