Provider Demographics
NPI:1942896329
Name:GERDIN PSYCHOLOGICAL SERVICES
Entity Type:Organization
Organization Name:GERDIN PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:A
Authorized Official - Last Name:GERDIN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, ABPP
Authorized Official - Phone:509-676-4313
Mailing Address - Street 1:701 W 7TH AVE STE 160A
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2835
Mailing Address - Country:US
Mailing Address - Phone:651-815-2524
Mailing Address - Fax:509-676-4314
Practice Address - Street 1:701 W 7TH AVE STE 160A
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2835
Practice Address - Country:US
Practice Address - Phone:651-815-2524
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-18
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty