Healthcare Provider Details

I. General information

NPI: 1548348907
Provider Name (Legal Business Name): SUREYYA S DIKMEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY OF WASHINGTON MEDICAL CTR 1959 NE PACIFIC ST
SEATTLE WA
98195-6157
US

IV. Provider business mailing address

PO BOX 50095
SEATTLE WA
98145-5095
US

V. Phone/Fax

Practice location:
  • Phone: 206-598-4295
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY00000467
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: