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General NPI Number Information
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NPI Number | 1154432078
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Entity Type | Organization
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Legal Business Name | TERRY S ONEIL PHD PS
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 11/24/2014
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Provider Practice Location Address
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Address Line | 1800 112TH AVE NE SUITE 322E
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City | BELLEVUE
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State | WA
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Zip | 98004-2938
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Country | US
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Telephone | 425-990-9840
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Fax | 425-990-8899
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Provider Business Mailing Address
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Address Line | PO BOX 52842
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City | BELLEVUE
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State | WA
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Zip | 98015-2842
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Country | US
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Telephone | 425-990-9840
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TERRY S O'NEIL
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Credential | PHD
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Telephone | 425-990-9840
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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 | PY00002323
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License Number State | WA
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