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General NPI Number Information
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NPI Number | 1811479249
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Entity Type | Organization
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Legal Business Name | CLAUDELLE R GLASGOW, PSYD, PLLC
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Dates
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Enumeration Date | 09/01/2018
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Last Update Date | 07/29/2019
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Provider Practice Location Address
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Address Line | 1105 23RD AVE
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City | SEATTLE
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State | WA
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Zip | 98122-4859
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Country | US
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Telephone | 312-804-3079
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Fax |
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Provider Business Mailing Address
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Address Line | 1105 23RD AVE
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City | SEATTLE
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State | WA
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Zip | 98122-4859
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Country | US
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Telephone | 312-804-3079
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Fax |
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Authorized Official
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Title or Position | LICENSED PSYCHOLOGIST
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Name | DR. CLAUDELLE R GLASGOW
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Credential | PSYD
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Telephone | 312-804-3079
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 2697
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License Number State | OR
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