Provider Demographics
NPI:1265585962
Name:GANLEY, ANNE LOUISE (PHD)
Entity type:Individual
Prefix:DR
First Name:ANNE
Middle Name:LOUISE
Last Name:GANLEY
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 1:2910 E MADISON ST
Mailing Address - Street 2:OFFICE 303
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-4214
Mailing Address - Country:US
Mailing Address - Phone:206-860-2444
Mailing Address - Fax:206-545-1720
Practice Address - Street 1:2910 E MADISON ST
Practice Address - Street 2:OFFICE 303
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-4214
Practice Address - Country:US
Practice Address - Phone:206-860-2444
Practice Address - Fax:206-545-1720
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00000585103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist