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General NPI Number Information
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NPI Number | 1801380191
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Entity Type | Organization
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Legal Business Name | NORTHWEST INTEGRATIVE PSYCHOTHERAPY, INC. P.S.
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Dates
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Enumeration Date | 06/19/2018
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Last Update Date | 06/22/2018
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Provider Practice Location Address
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Address Line | 3245 FAIRVIEW AVE E STE 310
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City | SEATTLE
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State | WA
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Zip | 98102
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Country | US
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Telephone | 206-324-3581
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Fax | 866-602-1865
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Provider Business Mailing Address
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Address Line | 3245 FAIRVIEW AVE E STE 310
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City | SEATTLE
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State | WA
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Zip | 98102-3053
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Country | US
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Telephone | 206-324-3581
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Fax | 866-602-1865
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Authorized Official
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Title or Position | OWNER/PSYCHOLOGIST
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Name | DR. PEGGY S WOOD
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Credential | PHD
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Telephone | 206-324-3581
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 1785
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License Number State | WA
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