Provider Demographics
NPI:1982752218
Name:BUCKMAN, TOBI ANNE (PSYD)
Entity Type:Individual
Prefix:
First Name:TOBI
Middle Name:ANNE
Last Name:BUCKMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 E 1ST ST
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:WA
Mailing Address - Zip Code:98520-5218
Mailing Address - Country:US
Mailing Address - Phone:360-538-2818
Mailing Address - Fax:360-538-5822
Practice Address - Street 1:206 E 1ST ST
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:WA
Practice Address - Zip Code:98520-5218
Practice Address - Country:US
Practice Address - Phone:360-538-2818
Practice Address - Fax:360-538-5822
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00004977101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health