Provider Demographics
NPI:1689715617
Name:COMRIE, MATTHEW DAVID (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:DAVID
Last Name:COMRIE
Suffix:
Gender:M
Credentials:PSYD
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 8481
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98042-0052
Mailing Address - Country:US
Mailing Address - Phone:253-639-3773
Mailing Address - Fax:253-638-7465
Practice Address - Street 1:17121 SE 270TH PL
Practice Address - Street 2:SUITE 203
Practice Address - City:COVINGTON
Practice Address - State:WA
Practice Address - Zip Code:98042-5431
Practice Address - Country:US
Practice Address - Phone:253-639-3773
Practice Address - Fax:253-638-7465
Is Sole Proprietor?:No
Enumeration Date:2007-02-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1422103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical