Healthcare Provider Details

I. General information

NPI: 1760741672
Provider Name (Legal Business Name): HALINA DOUR PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2012
Last Update Date: 10/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 S COLUMBIAN WAY
SEATTLE WA
98108-1565
US

IV. Provider business mailing address

1600 S COLUMBIAN WAY
SEATTLE WA
98108-1565
US

V. Phone/Fax

Practice location:
  • Phone: 206-764-2007
  • Fax:
Mailing address:
  • Phone: 206-764-2007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number60747360
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: