Healthcare Provider Details

I. General information

NPI: 1023862182
Provider Name (Legal Business Name): STRATAGEM EDUCATIONAL CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2024
Last Update Date: 04/15/2024
Certification Date: 04/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8318 196TH ST SW FL 2
EDMONDS WA
98026-6434
US

IV. Provider business mailing address

3730 RENTON AVE S
SEATTLE WA
98144-6819
US

V. Phone/Fax

Practice location:
  • Phone: 206-580-3723
  • Fax:
Mailing address:
  • Phone: 773-387-0036
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. GREGORY EUGENE MOY
Title or Position: PRACTICE OWNER
Credential: PHD
Phone: 206-580-3723