Provider Demographics
NPI:1568485308
Name:ULYSSES C WHITEHEAD
Entity Type:Organization
Organization Name:ULYSSES C WHITEHEAD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ULYSSES
Authorized Official - Middle Name:C
Authorized Official - Last Name:WHITEHEAD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:206-682-0569
Mailing Address - Street 1:600 FIRST AVE
Mailing Address - Street 2:PIONEER BLDG SUITE428
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104
Mailing Address - Country:US
Mailing Address - Phone:206-682-0569
Mailing Address - Fax:206-682-5082
Practice Address - Street 1:600 FIRST AVE
Practice Address - Street 2:PIONEER BLDG SUITE428
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104
Practice Address - Country:US
Practice Address - Phone:206-682-0569
Practice Address - Fax:206-682-5082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY593103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty