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General NPI Number Information
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NPI Number | 1588491005
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Entity Type | Organization
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Legal Business Name | BONNIE J MCINTOSH, PHD, PS
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Dates
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Enumeration Date | 09/18/2024
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Last Update Date | 09/25/2024
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Provider Practice Location Address
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Address Line | 1104 MARKET ST
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City | KIRKLAND
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State | WA
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Zip | 98033-5441
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Country | US
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Telephone | 206-830-0761
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Fax |
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Provider Business Mailing Address
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Address Line | 1104 MARKET ST
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City | KIRKLAND
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State | WA
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Zip | 98033-5441
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Country | US
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Telephone | 206-830-0761
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | BONNIE J MCINTOSH
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Credential |
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Telephone | 206-830-0761
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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 |
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License Number State |
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