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General NPI Number Information
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NPI Number | 1508440835
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Entity Type | Organization
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Legal Business Name | PAX PSYCHOTHERAPY PLLC
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Dates
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Enumeration Date | 05/12/2021
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Last Update Date | 11/09/2022
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Provider Practice Location Address
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Address Line | 1127 10TH AVE E STE 5
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City | SEATTLE
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State | WA
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Zip | 98102-4377
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Country | US
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Telephone | 206-309-7915
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Fax |
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Provider Business Mailing Address
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Address Line | 2722 EASTLAKE AVE E STE 300
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City | SEATTLE
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State | WA
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Zip | 98102-3143
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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
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Name | ANN CARTER
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Credential |
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Telephone | 206-309-7915
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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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