Provider Demographics
NPI:1659426757
Name:BOHN, PHILIP D (MSW)
Entity Type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:D
Last Name:BOHN
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6055 32ND AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-7230
Mailing Address - Country:US
Mailing Address - Phone:206-524-5056
Mailing Address - Fax:
Practice Address - Street 1:3216 NE 45TH PL STE 206
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-4028
Practice Address - Country:US
Practice Address - Phone:206-853-4795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW00006205101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health