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General NPI Number Information
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NPI Number | 1740642875
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Entity Type | Organization
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Legal Business Name | DEE MCGONIGLE
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Dates
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Enumeration Date | 03/28/2016
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Last Update Date | 03/28/2016
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Provider Practice Location Address
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Address Line | 4545 SAND POINT WAY NE 608
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City | SEATTLE
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State | WA
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Zip | 98105-3926
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Country | US
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Telephone | 206-528-1930
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Fax |
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Provider Business Mailing Address
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Address Line | 4545 SAND POINT WAY NE 608
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City | SEATTLE
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State | WA
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Zip | 98105-3926
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Country | US
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Telephone | 206-528-1930
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. DEE J MCGONIGLE
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Credential | MD
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Telephone | 206-528-1930
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320700000X
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Taxonomy Name | Physical Disabilities Residential Treatment Facility
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License Number | 00008976
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License Number State | WA
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