Healthcare Provider Details

I. General information

NPI: 1992660674
Provider Name (Legal Business Name): JOEY COLLINS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13814 50TH AVE SE
EVERETT WA
98208-9564
US

IV. Provider business mailing address

13814 50TH AVE SE
EVERETT WA
98208-9564
US

V. Phone/Fax

Practice location:
  • Phone: 425-213-6120
  • Fax:
Mailing address:
  • Phone: 425-213-6120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY00003094
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: