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General NPI Number Information
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NPI Number | 1245477017
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Entity Type | Organization
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Legal Business Name | PHILLIP A. COHEN, MD, PS
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Dates
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Enumeration Date | 01/14/2009
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 7817 12TH AVE NE
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City | SEATTLE
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State | WA
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Zip | 98115-4320
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Country | US
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Telephone | 206-526-5550
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Fax |
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Provider Business Mailing Address
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Address Line | 7817 12TH AVE NE
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City | SEATTLE
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State | WA
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Zip | 98115-4320
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Country | US
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Telephone | 206-526-5550
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. PHILLIP A COHEN
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Credential | M.D.
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Telephone | 206-526-5550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | MD 00013177
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License Number State | WA
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