Provider Demographics
NPI:1326189507
Name:SEATTLE PSYCHOLOGISTS, PS
Entity Type:Organization
Organization Name:SEATTLE PSYCHOLOGISTS, PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:NORA
Authorized Official - Last Name:ROLL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:206-545-7500
Mailing Address - Street 1:5413 MERIDIAN AVE N
Mailing Address - Street 2:SUITE A
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-6168
Mailing Address - Country:US
Mailing Address - Phone:206-545-7500
Mailing Address - Fax:206-632-4767
Practice Address - Street 1:5413 MERIDIAN AVE N
Practice Address - Street 2:SUITE A
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-6168
Practice Address - Country:US
Practice Address - Phone:206-545-7500
Practice Address - Fax:206-632-4767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty