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General NPI Number Information
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NPI Number | 1497178206
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Entity Type | Organization
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Legal Business Name | SNOHOMISH PSYCHOLOGY ASSOCIATES, PLLC
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Dates
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Enumeration Date | 01/29/2014
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Last Update Date | 01/29/2014
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Provider Practice Location Address
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Address Line | 1721 HEWITT AVE SUITE 416
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City | EVERETT
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State | WA
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Zip | 98201-3570
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Country | US
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Telephone | 425-789-1073
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 13221
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City | EVERETT
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State | WA
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Zip | 98206-3221
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/PSYCHOLOGIST
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Name | DR. KIRA MAUSETH
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Credential | PH.D.
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Telephone | 425-789-1073
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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 | PY60073218
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License Number State | WA
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