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Contact Information

LIFESPAN PSYCHOLOGICAL SERVICES, PS
11290 SUNRISE DR NE
SUITE B
BAINBRIDGE ISLAND, WA98110-1353
 Phone: 206-780-7782
 Fax: 206-780-1964
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
 

Prescribing (Medical)

103TP0016X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for LIFESPAN PSYCHOLOGICAL SERVICES PS · (Female)

NPI Number 1366503633
Status Active
Credentials
Entity Individual
Enumeration date 12/12/2006
Last updated 09/26/2025 - About 8 months ago
Sole proprietor 1 Not specified
Identifiers Not Available
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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