Provider Demographics
NPI:1841681392
Name:NORTHWEST CENTER FOR HEALTH PSYCHOLOGY, PLLC
Entity type:Organization
Organization Name:NORTHWEST CENTER FOR HEALTH PSYCHOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:CASANDRA
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:206-824-3950
Mailing Address - Street 1:22517 7TH AVE S
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:WA
Mailing Address - Zip Code:98198-6820
Mailing Address - Country:US
Mailing Address - Phone:206-824-3950
Mailing Address - Fax:206-870-9051
Practice Address - Street 1:17022 SE WAX RD
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:WA
Practice Address - Zip Code:98042-9122
Practice Address - Country:US
Practice Address - Phone:206-824-3950
Practice Address - Fax:206-870-9051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-05
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00002983103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty