Healthcare Provider Details

I. General information

NPI: 1306917679
Provider Name (Legal Business Name): WILLIAM C HEUSLER PSYD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2006
Last Update Date: 05/16/2025
Certification Date: 05/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1728 W MARINE VIEW DR STE 109
EVERETT WA
98201-2094
US

IV. Provider business mailing address

1728 W MARINE VIEW DR STE 109
EVERETT WA
98201-2094
US

V. Phone/Fax

Practice location:
  • Phone: 206-909-7633
  • Fax: 425-230-0312
Mailing address:
  • Phone: 206-909-7633
  • Fax: 425-230-0312

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY60063022
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: