MEDICARE: DR. DENNIS RICHARD POLLACK PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	511	WA

General Provider Information

NPI Number	:	1427272384
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENNIS RICHARD POLLACK PH.D.

Provider Business Mailing Address
First Line	:	9 S WASHINGTON ST
Second Line	:	SUITE 709
City	:	SPOKANE
State	:	WA
Zip	:	99201-3719
Country	:	US
Telephone Number	:	509-747-1456
Fax Number	:	509-448-4420

Provider Business Practice Location Address
First Line	:	9 S WASHINGTON ST
Second Line	:	SUITE 709
City	:	SPOKANE
State	:	WA
Zip	:	99201-3719
Country	:	US
Telephone Number	:	509-747-1456
Fax Number	:	509-448-4420

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2007
Last Update Date	:	07/08/2007

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