Healthcare Provider Details

I. General information

NPI: 1902480825
Provider Name (Legal Business Name): LINDA ANDERSON PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2021
Last Update Date: 05/06/2021
Certification Date: 05/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UW COUNSELING CENTER 1410 NE CAMPUS PKWY, 401 SCHMITZ
SEATTLE WA
98195-5830
US

IV. Provider business mailing address

PO BOX 355830
SEATTLE WA
98195-5830
US

V. Phone/Fax

Practice location:
  • Phone: 120-694-0836
  • Fax:
Mailing address:
  • Phone: 206-543-1240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPY60316112
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: