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General NPI Number Information
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NPI Number | 1467148163
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Entity Type | Organization
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Legal Business Name | THE DORN CLINIC, PLLC
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Dates
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Enumeration Date | 04/14/2023
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Last Update Date | 04/14/2023
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Provider Practice Location Address
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Address Line | 1529 QUEEN ANNE AVE N APT 305
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City | SEATTLE
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State | WA
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Zip | 98109-2878
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Country | US
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Telephone | 910-742-5462
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Fax |
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Provider Business Mailing Address
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Address Line | 1529 QUEEN ANNE AVE N APT 305
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City | SEATTLE
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State | WA
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Zip | 98109-2878
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Country | US
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Telephone | 910-742-5462
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. DANIELLE MARIANNE DORN
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Credential | PSYD
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Telephone | 910-742-5462
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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 |
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License Number State |
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