Healthcare Provider Details

I. General information

NPI: 1538288691
Provider Name (Legal Business Name): DEBORAH LYNN DUNPHY PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 04/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

406 S 1ST ST STE 300
MOUNT VERNON WA
98273-3897
US

IV. Provider business mailing address

2411 N 24TH PL
MOUNT VERNON WA
98273-5867
US

V. Phone/Fax

Practice location:
  • Phone: 360-588-4626
  • Fax: 360-336-3270
Mailing address:
  • Phone: 360-982-2324
  • Fax: 360-336-6866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPY00003347
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License NumberPY00003347
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY00003347
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: