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Contact Information

WASHINGTON STATE PSYCHOLOGICAL SERVICES, LLC
5105 200TH ST SW STE 100
LYNNWOOD, WA98036-6397
 Phone: 425-387-6972
 Fax: 425-377-0701
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Rehabilitation

103TR0400X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for WASHINGTON STATE PSYCHOLOGICAL SERVICES, LLC

NPI # 1801130976
LBN Legal business name WASHINGTON STATE PSYCHOLOGICAL SERVICES, LLC
Authorized official BRENDA HAVELLANA - (NEUROPSYCHOLOGIST)
Entity Organization
Organization subpart 1 No
Enumeration date 11/15/2012
Last updated 11/15/2012 - About 14 years ago
Identifiers
WA License # PY60014648
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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