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General NPI Number Information
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NPI Number | 1083184550
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Entity Type | Individual
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Provider Name | ROBERT A BEATTEY JR. PHD
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Gender | Male
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Dates
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Enumeration Date | 11/27/2018
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Last Update Date | 10/24/2021
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Provider Practice Location Address
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Address Line | 910 10TH AVE E APT 205
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City | SEATTLE
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State | WA
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Zip | 98102-4556
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Country | US
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Telephone | 714-421-3785
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 22351
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City | SEATTLE
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State | WA
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Zip | 98122-0351
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Country | US
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Telephone | 800-499-7105
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY-004928
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY60888285
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License Number State | WA
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