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Contact Information

MAGNOLIA PSYCHIATRY, LLC
12729 NORTHUP WAY STE 6
BELLEVUE, WA98005-1935
 Phone: 425-467-1000
 Fax: 425-467-0100
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Addiction Psychiatry

2084P0802X 86 Physician/Neuropsychiatry
Indicates primary specialty

NPI Profile & details for MAGNOLIA PSYCHIATRY LLC · (Female)

NPI # 1003346594
Status Active
Credentials
Entity Individual
Enumeration date 06/15/2017
Last updated 04/17/2019 - About 7 years ago
Sole proprietor 1 Not specified
Identifiers
  • WA License # MD00036813
  • WA Other MD00036813 WASHINGTON STATE MEDICAL LICENSE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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