Healthcare Provider Details

I. General information

NPI: 1255069795
Provider Name (Legal Business Name): CHRISTINE PAPROCKI PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2022
Last Update Date: 08/11/2022
Certification Date: 08/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1505 WESTLAKE AVE N STE 920
SEATTLE WA
98109-6240
US

IV. Provider business mailing address

4550 51ST PL SW
SEATTLE WA
98116-3902
US

V. Phone/Fax

Practice location:
  • Phone: 206-386-3103
  • Fax:
Mailing address:
  • Phone: 206-850-1950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY60628913
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: