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General NPI Number Information
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NPI Number | 1356648794
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Entity Type | Individual
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Provider Name | WILLIAM ROEDEL PHD
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Gender | Male
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Dates
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Enumeration Date | 02/21/2011
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 7614 195TH ST SW STE 101
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City | EDMONDS
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State | WA
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Zip | 98026-6260
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Country | US
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Telephone | 425-775-4059
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Fax |
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Provider Business Mailing Address
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Address Line | 1512 N HERRON RD NW
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City | LAKEBAY
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State | WA
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Zip | 98349-8009
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Country | US
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Telephone | 425-599-5518
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | PY00003762
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License Number State | WA
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