Provider Demographics
NPI:1639367352
Name:DR. ASTRID DAVIDSON, PSY,D., INC.
Entity Type:Organization
Organization Name:DR. ASTRID DAVIDSON, PSY,D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ASTRID
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIDSON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:425-455-4890
Mailing Address - Street 1:PO BOX 7083
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98008-1083
Mailing Address - Country:US
Mailing Address - Phone:425-455-4890
Mailing Address - Fax:425-643-0352
Practice Address - Street 1:14042 NE 8TH ST STE 102
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-4142
Practice Address - Country:US
Practice Address - Phone:425-455-4890
Practice Address - Fax:425-643-0352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00002916103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8804551Medicare UPIN
8804549Medicare UPIN