Healthcare Provider Details

I. General information

NPI: 1932494416
Provider Name (Legal Business Name): COLETTE DEMONTE PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2011
Last Update Date: 12/27/2024
Certification Date: 12/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2202 SOUTH CEDAR ST #300/#200
TACOMA WA
98405
US

IV. Provider business mailing address

P.O. BOX 5299 MS: 737-3-PCON
TACOMA WA
98415-0299
US

V. Phone/Fax

Practice location:
  • Phone: 253-301-5280
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY60448657
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY60448657
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: