Provider Demographics
NPI:1598841355
Name:COWLEY, DEBORAH SUZANNE
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:SUZANNE
Last Name:COWLEY
Suffix:
Gender:F
Credentials:
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 50095
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98145-5095
Mailing Address - Country:US
Mailing Address - Phone:206-543-6420
Mailing Address - Fax:
Practice Address - Street 1:UWMC-ROOSEVELT
Practice Address - Street 2:4225 ROOSEVELT WAY NE SUITE 306
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-4794
Practice Address - Country:US
Practice Address - Phone:206-598-7792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000192192084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1598841355Medicaid
WA260014972OtherRAIL ROAD MEDICARE
2487OtherINTERNAL ID-MOTOR VEHICLE ID
WA0175524OtherL&I
WA000101083Medicare PIN
WA260014972OtherRAIL ROAD MEDICARE
WAAB04067Medicare PIN