Healthcare Provider Details
I. General information
NPI: 1730264557
Provider Name (Legal Business Name): FELICE ORLICH
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/27/2006
Last Update Date: 10/14/2024
Certification Date: 10/14/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
CENTER ON HUMAN DEVELOPMENT AND DIS 1959 NE PACIFIC ST
SEATTLE WA
98195-7920
US
IV. Provider business mailing address
PO BOX 50095
SEATTLE WA
98145-5095
US
V. Phone/Fax
- Phone: 206-685-1242
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC2200X |
| Taxonomy | Clinical Child & Adolescent Psychologist |
| License Number | PY00002077 |
| License Number State | WA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | PY00002077 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: