Healthcare Provider Details

I. General information

NPI: 1932319936
Provider Name (Legal Business Name): MARIAM ARAUJO PH. D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CHDD COLUMBIA RD BOX 357920 ROOM 205
SEATTLE WA
98195-7920
US

IV. Provider business mailing address

CHDD COLUMBIA RD BOX 357920 ROOM 205
SEATTLE WA
98195-7920
US

V. Phone/Fax

Practice location:
  • Phone: 206-543-9930
  • Fax: 206-598-7815
Mailing address:
  • Phone: 206-543-9930
  • Fax: 206-598-7815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY00003077
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: