Provider Demographics
NPI:1477613040
Name:FOREMAN-RORRER, MARY RAWSON (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:RAWSON
Last Name:FOREMAN-RORRER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:RAWSON
Other - Last Name:FOREMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:10512 NE 68TH ST STE C202
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-7063
Mailing Address - Country:US
Mailing Address - Phone:425-830-9867
Mailing Address - Fax:
Practice Address - Street 1:1836 WESTLAKE AVE N
Practice Address - Street 2:SUITE 300B
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-2755
Practice Address - Country:US
Practice Address - Phone:425-830-9867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60039731103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist