=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376768515
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | STEVEN K. REED PHD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/14/2007
-----------------------------------------------------
Last Update Date | 11/21/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1715 114TH AVE SE SUITE 200
-----------------------------------------------------
City | BELLEVUE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98004-6945
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 425-455-5189
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 40194
-----------------------------------------------------
City | BELLEVUE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98015-4194
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 425-455-5189
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC0700X
-----------------------------------------------------
Taxonomy Name | Clinical Psychologist
-----------------------------------------------------
License Number | 1071
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------