Healthcare Provider Details

I. General information

NPI: 1285050443
Provider Name (Legal Business Name): JOSHUA HAYDEN PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2014
Last Update Date: 03/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1959 NE PACIFIC ST NW120
SEATTLE WA
98195-0001
US

IV. Provider business mailing address

4727 RAVENNA AVE NE APT 303
SEATTLE WA
98105-4160
US

V. Phone/Fax

Practice location:
  • Phone: 206-598-3732
  • Fax:
Mailing address:
  • Phone: 724-518-1239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: