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General NPI Number Information
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NPI Number | 1053511360
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Entity Type | Organization
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Legal Business Name | JOSEPH S. VIZZARD, PH.D., P.S,
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Dates
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Enumeration Date | 07/24/2007
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Last Update Date | 04/09/2013
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Provider Practice Location Address
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Address Line | 8311 212TH ST SW
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City | EDMONDS
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State | WA
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Zip | 98026-7443
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Country | US
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Telephone | 425-771-8011
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Fax | 425-771-8009
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Provider Business Mailing Address
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Address Line | 8311 212TH ST SW
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City | EDMONDS
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State | WA
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Zip | 98026-7443
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Country | US
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Telephone | 425-771-8011
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Fax | 425-771-8009
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Authorized Official
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Title or Position | .PRESIDENT/PSYCHOLOGIST
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Name | DR. JOSEH STEPHEN VIZZARD
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Credential | PH.D
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Telephone | 425-771-8011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY0001307
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License Number State | WA
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