Provider Demographics
NPI:1609328731
Name:EICHLER WEST, ROGENE M (PHD QEEGD BCN CC)
Entity Type:Individual
Prefix:DR
First Name:ROGENE
Middle Name:M
Last Name:EICHLER WEST
Suffix:
Gender:F
Credentials:PHD QEEGD BCN CC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 1ST AVE S
Mailing Address - Street 2:SUITE 310
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-2575
Mailing Address - Country:US
Mailing Address - Phone:206-456-5454
Mailing Address - Fax:
Practice Address - Street 1:219 1ST AVE S STE 310
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2551
Practice Address - Country:US
Practice Address - Phone:206-456-5454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-24
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA246ZE0500X
WACL60528100101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No246ZE0500XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherEEG