Healthcare Provider Details

I. General information

NPI: 1306996400
Provider Name (Legal Business Name): DAVID MOORE BARRETT PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 DAYTON ST STE D
EDMONDS WA
98020-3476
US

IV. Provider business mailing address

555 DAYTON ST STE D
EDMONDS WA
98020-3476
US

V. Phone/Fax

Practice location:
  • Phone: 425-778-8775
  • Fax: 425-771-7266
Mailing address:
  • Phone: 425-778-8775
  • Fax: 425-771-7266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY00000594
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: