Healthcare Provider Details

I. General information

NPI: 1699226845
Provider Name (Legal Business Name): HELEN WIDLANSKY, PH.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2016
Last Update Date: 10/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 NE BLAKELEY ST SUITE C
SEATTLE WA
98105-3100
US

IV. Provider business mailing address

2900 NE BLAKELEY ST SUITE C
SEATTLE WA
98105-3100
US

V. Phone/Fax

Practice location:
  • Phone: 206-946-2365
  • Fax:
Mailing address:
  • Phone: 206-946-2365
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License NumberPY60513253
License Number StateWA

VIII. Authorized Official

Name: DR. HELEN SHERWOOD WIDLANSKY
Title or Position: LICENSED CLINICAL PSYCHOLOGIST
Credential: PH.D.
Phone: 206-946-2365