Healthcare Provider Details

I. General information

NPI: 1225186802
Provider Name (Legal Business Name): BARBARA GROTE PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 BROADWAY SUITE 313
SEATTLE WA
98122-4397
US

IV. Provider business mailing address

444 26TH AVE E
SEATTLE WA
98112-4729
US

V. Phone/Fax

Practice location:
  • Phone: 206-860-0860
  • Fax: 206-860-2829
Mailing address:
  • Phone: 206-330-6175
  • Fax: 206-860-2829

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY00003587
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: