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General NPI Number Information
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NPI Number | 1578349486
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Entity Type | Organization
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Legal Business Name | STILLPOINT PSYCHIATRY
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Dates
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Enumeration Date | 09/06/2023
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Last Update Date | 09/06/2023
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Provider Practice Location Address
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Address Line | 2708 XANADU LN
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City | LANGLEY
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State | WA
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Zip | 98260-9213
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Country | US
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Telephone | 206-795-0378
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 192
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City | LANGLEY
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State | WA
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Zip | 98260-0192
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Country | US
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Telephone | 206-795-0378
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Fax |
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Authorized Official
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Title or Position | PMHNP
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Name | MARY THERESA BOLLES HOLDER
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Credential | DNP
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Telephone | 206-795-0378
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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