Healthcare Provider Details

I. General information

NPI: 1841681392
Provider Name (Legal Business Name): NORTHWEST CENTER FOR HEALTH PSYCHOLOGY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2015
Last Update Date: 02/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17022 SE WAX RD
COVINGTON WA
98042-9122
US

IV. Provider business mailing address

22517 7TH AVE S
DES MOINES WA
98198-6820
US

V. Phone/Fax

Practice location:
  • Phone: 206-824-3950
  • Fax: 206-870-9051
Mailing address:
  • Phone: 206-824-3950
  • Fax: 206-870-9051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number00002983
License Number StateWA

VIII. Authorized Official

Name: DR. MAUREEN CASANDRA PIERCE
Title or Position: PSYCHOLOGIST/OWNER
Credential: PH.D.
Phone: 206-824-3950