Provider Demographics
NPI:1811269624
Name:BLUESTONE PSYCHOLOGICAL SERVICES, LLC
Entity type:Organization
Organization Name:BLUESTONE PSYCHOLOGICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HANSON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:425-775-4059
Mailing Address - Street 1:7522 221ST PL SW
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-8029
Mailing Address - Country:US
Mailing Address - Phone:425-775-4059
Mailing Address - Fax:425-775-7210
Practice Address - Street 1:7522 221ST PL SW
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-8029
Practice Address - Country:US
Practice Address - Phone:425-775-4059
Practice Address - Fax:425-775-7210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-08
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00005434101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty