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General NPI Number Information
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NPI Number | 1073084935
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Entity Type | Individual
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Provider Name | ANN MARIE ROEPKE PH.D.
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Gender | Female
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Dates
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Enumeration Date | 12/17/2018
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Last Update Date | 12/17/2018
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Provider Practice Location Address
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Address Line | 4741 RAINIER AVE S
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City | SEATTLE
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State | WA
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Zip | 98118-1657
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Country | US
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Telephone | 267-901-4183
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Fax |
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Provider Business Mailing Address
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Address Line | 1702 S BAYVIEW ST
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City | SEATTLE
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State | WA
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Zip | 98144-5123
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Country | US
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Telephone | 267-901-4183
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY60720638
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License Number State | WA
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