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General NPI Number Information
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NPI Number | 1780198424
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Entity Type | Organization
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Legal Business Name | RENEE GILBERT, PH.D.
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Dates
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Enumeration Date | 11/16/2017
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Last Update Date | 11/16/2017
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Provider Practice Location Address
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Address Line | 40 LAKE BELLEVUE DR STE 100
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City | BELLEVUE
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State | WA
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Zip | 98005-2480
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Country | US
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Telephone | 425-455-5400
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Fax | 425-688-1741
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Provider Business Mailing Address
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Address Line | PO BOX 1573
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City | BELLEVUE
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State | WA
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Zip | 98009-1573
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Country | US
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Telephone | 425-455-5400
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Fax | 425-688-1741
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Authorized Official
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Title or Position | OWNWE
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Name | DR. RENEE GILBERT
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Credential | PH.D.
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Telephone | 425-455-5400
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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 | 1112
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License Number State | WA
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