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General NPI Number Information
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NPI Number | 1073661286
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Entity Type | Organization
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Legal Business Name | BEHAVIORAL MEDICINE NORTHWEST, P.S.
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Dates
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Enumeration Date | 01/07/2007
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Last Update Date | 03/01/2013
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Provider Practice Location Address
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Address Line | 345 KNECHTEL WAY NE #111
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City | BAINBRIDGE ISLAND
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State | WA
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Zip | 98110-2860
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Country | US
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Telephone | 206-720-6155
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Fax | 206-866-6979
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Provider Business Mailing Address
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Address Line | PO BOX 1457
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City | POULSBO
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State | WA
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Zip | 98370-0160
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Country | US
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Telephone | 206-720-6155
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Fax | 360-697-3761
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FRANCINE HAY POWEL
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Credential | PH.D.
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Telephone | 206-720-6155
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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 | 727
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License Number State | WA
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