Provider Demographics
NPI:1376583039
Name:ALLEN, DAVID B (PHD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:B
Last Name:ALLEN
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 1:12221 NE 8TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-3113
Mailing Address - Country:US
Mailing Address - Phone:425-454-7321
Mailing Address - Fax:425-451-9850
Practice Address - Street 1:12221 NE 8TH ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-3113
Practice Address - Country:US
Practice Address - Phone:425-454-7321
Practice Address - Fax:425-451-9850
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA630103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical