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General NPI Number Information
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NPI Number | 1568485308
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Entity Type | Organization
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Legal Business Name | ULYSSES C WHITEHEAD
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 600 FIRST AVE PIONEER BLDG SUITE428
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City | SEATTLE
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State | WA
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Zip | 98104
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Country | US
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Telephone | 206-682-0569
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Fax | 206-682-5082
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Provider Business Mailing Address
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Address Line | 600 FIRST AVE PIONEER BLDG SUITE428
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City | SEATTLE
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State | WA
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Zip | 98104
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Country | US
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Telephone | 206-682-0569
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Fax | 206-682-5082
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | ULYSSES C WHITEHEAD
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Credential | PH.D
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Telephone | 206-682-0569
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY593
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License Number State | WA
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