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General NPI Number Information
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NPI Number | 1497943377
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Entity Type | Organization
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Legal Business Name | GAIL T. WEYERHAEUSER, PHD PLLC
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Dates
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Enumeration Date | 10/04/2007
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Last Update Date | 07/13/2010
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Provider Practice Location Address
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Address Line | 1250 PACIFIC AVE SUITE 875
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City | TACOMA
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State | WA
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Zip | 98402-4318
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Country | US
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Telephone | 253-572-2745
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Fax | 253-572-2947
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Provider Business Mailing Address
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Address Line | 1250 PACIFIC AVE SUITE 875
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City | TACOMA
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State | WA
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Zip | 98402-4318
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Country | US
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Telephone | 253-572-2745
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Fax | 253-572-2947
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. GAIL TOYCEN WEYERHAEUSER
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Credential | PHD
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Telephone | 253-572-2745
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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 | PY2449
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License Number State | WA
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