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General NPI Number Information
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NPI Number | 1427715325
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Entity Type | Organization
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Legal Business Name | SPRUCE PSYCHIATRIC
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Dates
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Enumeration Date | 11/26/2021
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Last Update Date | 07/08/2022
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Provider Practice Location Address
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Address Line | 2817 NE 55TH ST STE C
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City | SEATTLE
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State | WA
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Zip | 98105-5536
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Country | US
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Telephone | 206-486-1500
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Fax | 206-775-7215
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Provider Business Mailing Address
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Address Line | 2817 NE 55TH ST STE C
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City | SEATTLE
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State | WA
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Zip | 98105-5536
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Country | US
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Telephone | 206-486-1500
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Fax | 206-775-7215
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | GAVIN BRINK
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Credential |
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Telephone | 206-486-1500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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