Healthcare Provider Details

I. General information

NPI: 1841077062
Provider Name (Legal Business Name): DOCKSIDE PSYCHIATRY CLINIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2023
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14524 MAIN ST NE STE 201
DUVALL WA
98019-8641
US

IV. Provider business mailing address

19201 NE WOODINVILLE DUVALL RD
WOODINVILLE WA
98077-9482
US

V. Phone/Fax

Practice location:
  • Phone: 206-210-8989
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: NATALIE DREYFOOS
Title or Position: PRACTICE OWNER
Credential: DNP, PMHNP-BC
Phone: 931-449-0697