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General NPI Number Information
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NPI Number | 1598530248
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Entity Type | Organization
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Legal Business Name | PACIFIC COAST PSYCHOLOGICAL SERVICES LLC
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Dates
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Enumeration Date | 11/21/2023
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Last Update Date | 03/08/2024
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Provider Practice Location Address
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Address Line | 3515 SW ALASKA ST
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City | SEATTLE
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State | WA
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Zip | 98126-2730
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Country | US
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Telephone | 253-234-7226
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Fax |
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Provider Business Mailing Address
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Address Line | 5326 SW MANNING ST
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City | SEATTLE
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State | WA
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Zip | 98116-3128
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Country | US
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Telephone | 253-234-7226
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SAMUEL COLLIER
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Credential | PSYD
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Telephone | 253-234-7226
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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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Taxonomy #2
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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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