Healthcare Provider Details

I. General information

NPI: 1588214167
Provider Name (Legal Business Name): ROSEWOOD PSYCHOLOGY, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2019
Last Update Date: 01/12/2025
Certification Date: 01/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N 36TH ST STE 321
SEATTLE WA
98103-8698
US

IV. Provider business mailing address

600 N 36TH ST STE 321
SEATTLE WA
98103-8698
US

V. Phone/Fax

Practice location:
  • Phone: 206-880-0977
  • Fax: 206-299-4617
Mailing address:
  • Phone: 206-880-0977
  • Fax: 206-299-4617

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN DEBERRY
Title or Position: PRESIDENT
Credential: PHD
Phone: 206-880-0977