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General NPI Number Information
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NPI Number | 1205356698
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Entity Type | Individual
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Provider Name | JOHN DEBERRY PH.D.
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Gender | Male
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Dates
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Enumeration Date | 06/26/2017
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Last Update Date | 01/12/2025
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Provider Practice Location Address
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Address Line | 600 N 36TH ST STE 321
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City | SEATTLE
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State | WA
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Zip | 98103-8698
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Country | US
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Telephone | 206-880-0977
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Fax | 206-299-4617
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Provider Business Mailing Address
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Address Line | 600 N 36TH ST STE 321
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City | SEATTLE
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State | WA
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Zip | 98103-8698
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Country | US
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Telephone | 206-880-0977
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Fax | 206-299-4617
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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 | PY60729333
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | PY60729333
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY60729333
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License Number State | WA
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