Healthcare Provider Details

I. General information

NPI: 1336209634
Provider Name (Legal Business Name): PACIFIC NEUROPSYCHIATRIC INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2006
Last Update Date: 11/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6300 9TH AVENUE NE SUITE 353
SEATTLE WA
98115-8516
US

IV. Provider business mailing address

6300 9TH AVENUE NE SUITE 353
SEATTLE WA
98115-8516
US

V. Phone/Fax

Practice location:
  • Phone: 206-527-6289
  • Fax: 206-892-9689
Mailing address:
  • Phone: 206-527-6289
  • Fax: 206-892-9689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License Number023511
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number023511
License Number StateWA

VIII. Authorized Official

Name: DR. VERNON M NEPPE
Title or Position: DIRECTOR
Credential: MD, PHD
Phone: 206-527-6289