Provider Demographics
NPI:1407495211
Name:ELLEN A. BEGLEY, PH.D. PLLC
Entity Type:Organization
Organization Name:ELLEN A. BEGLEY, PH.D. PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:BEGLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:206-650-4504
Mailing Address - Street 1:3429 FREMONT PL N STE 316
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-8661
Mailing Address - Country:US
Mailing Address - Phone:206-650-4504
Mailing Address - Fax:206-547-5298
Practice Address - Street 1:3417 FREMONT AVE N STE 316
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-3411
Practice Address - Country:US
Practice Address - Phone:206-650-4504
Practice Address - Fax:206-547-5298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-26
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty