Provider Demographics
NPI:1417021833
Name:BARRY, BARBARA (PHD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:
Last Name:BARRY
Suffix:
Gender:F
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:PO BOX 565
Mailing Address - Street 2:
Mailing Address - City:FREELAND
Mailing Address - State:WA
Mailing Address - Zip Code:98249-0565
Mailing Address - Country:US
Mailing Address - Phone:206-448-2107
Mailing Address - Fax:855-221-6770
Practice Address - Street 1:919 3RD ST STE 203
Practice Address - Street 2:
Practice Address - City:LANGLEY
Practice Address - State:WA
Practice Address - Zip Code:98260-9230
Practice Address - Country:US
Practice Address - Phone:206-448-2107
Practice Address - Fax:855-221-6770
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00001413103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB37636Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER