Healthcare Provider Details

I. General information

NPI: 1043539018
Provider Name (Legal Business Name): UW CARE CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2010
Last Update Date: 05/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3945 15TH AVE NE
SEATTLE WA
98105-6607
US

IV. Provider business mailing address

PO BOX 351415 3945 15TH AVE NE
SEATTLE WA
98195-1415
US

V. Phone/Fax

Practice location:
  • Phone: 206-897-1603
  • Fax: 206-685-9577
Mailing address:
  • Phone: 206-897-1603
  • Fax: 206-685-9577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License NumberPSY00002359
License Number StateWA

VIII. Authorized Official

Name: JULIE ANNE OSTERLING
Title or Position: CLINICAL DIRECTOR
Credential: PHD
Phone: 206-897-1603