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General NPI Number Information
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NPI Number | 1326694142
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Entity Type | Organization
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Legal Business Name | EMERALD CITY NEUROPSYCHOLOGY PLLC
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Dates
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Enumeration Date | 08/16/2019
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Last Update Date | 08/17/2019
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Provider Practice Location Address
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Address Line | 1700 WESTLAKE AVE N STE 400
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City | SEATTLE
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State | WA
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Zip | 98109-6236
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Country | US
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Telephone | 206-384-1414
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Fax |
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Provider Business Mailing Address
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Address Line | 7724 35TH AVE NE UNIT 15538
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City | SEATTLE
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State | WA
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Zip | 98115-3282
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KATHERINE BOWEN
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Credential | PHD
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Telephone | 206-384-1414
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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