Healthcare Provider Details

I. General information

NPI: 1669565354
Provider Name (Legal Business Name): SUSAN RAAB-COHEN PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2003 WESTERN AVE. SUITE 340
SEATTLE WA
98121-2213
US

IV. Provider business mailing address

2003 WESTERN AVE. SUITE 340
SEATTLE WA
98121-2213
US

V. Phone/Fax

Practice location:
  • Phone: 206-443-9810
  • Fax: 206-448-4899
Mailing address:
  • Phone: 206-443-9810
  • Fax: 206-448-4899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number828
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: