Provider Demographics
NPI:1881970911
Name:SOLECK, GEOFFREY DEAN (PH D)
Entity type:Individual
Prefix:
First Name:GEOFFREY
Middle Name:DEAN
Last Name:SOLECK
Suffix:
Gender:M
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2702 S 42ND ST
Mailing Address - Street 2:SUITE 310
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98409-7324
Mailing Address - Country:US
Mailing Address - Phone:253-472-7844
Mailing Address - Fax:253-472-8474
Practice Address - Street 1:2702 S 42ND ST
Practice Address - Street 2:SUITE 310
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98409-7324
Practice Address - Country:US
Practice Address - Phone:253-472-7844
Practice Address - Fax:253-472-8474
Is Sole Proprietor?:No
Enumeration Date:2011-11-03
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY60109769103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling