Healthcare Provider Details

I. General information

NPI: 1417021833
Provider Name (Legal Business Name): BARBARA BARRY PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 09/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

919 3RD ST STE 203
LANGLEY WA
98260-9230
US

IV. Provider business mailing address

PO BOX 565
FREELAND WA
98249-0565
US

V. Phone/Fax

Practice location:
  • Phone: 206-448-2107
  • Fax: 855-221-6770
Mailing address:
  • Phone: 206-448-2107
  • Fax: 855-221-6770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number00001413
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: