Provider Demographics
NPI:1629402169
Name:THOMPSON, STEPHANIE FENGLER (PHD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:FENGLER
Last Name:THOMPSON
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 1:1817 QUEEN ANNE AVE N STE 404
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-2876
Mailing Address - Country:US
Mailing Address - Phone:206-327-8632
Mailing Address - Fax:
Practice Address - Street 1:1817 QUEEN ANNE AVE N STE 404
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109
Practice Address - Country:US
Practice Address - Phone:206-327-8632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-31
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist