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General NPI Number Information
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NPI Number | 1427365766
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Entity Type | Individual
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Provider Name | CLARA NELE DOCTOLERO PSY.D
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Gender | Female
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Dates
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Enumeration Date | 09/08/2010
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Last Update Date | 01/20/2015
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Provider Practice Location Address
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Address Line | 509 OLIVE WAY SUITE 853
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City | SEATTLE
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State | WA
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Zip | 98101-1720
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Country | US
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Telephone | 206-258-3703
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Fax |
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Provider Business Mailing Address
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Address Line | 509 OLIVE WAY SUITE 853
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City | SEATTLE
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State | WA
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Zip | 98101-1720
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Country | US
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Telephone | 206-258-3703
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY60084603
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License Number State | WA
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