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General NPI Number Information
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NPI Number | 1861687188
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Entity Type | Organization
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Legal Business Name | ISLAND PSYCHIATRIC SERVICES
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Dates
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Enumeration Date | 09/10/2007
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Last Update Date | 09/10/2007
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Provider Practice Location Address
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Address Line | 374 NORTH BEACH ROAD
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City | EASTSOUND
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State | WA
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Zip | 98245
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Country | US
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Telephone | 360-376-3558
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Fax | 360-376-3558
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Provider Business Mailing Address
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Address Line | PO BOX 1449
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City | EASTSOUND
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State | WA
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Zip | 98245-1449
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Country | US
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Telephone | 360-376-3558
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Fax | 360-376-3558
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Authorized Official
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Title or Position | PSYCHIATRIC NURSE PRACTITIONER
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Name | CARLA L. WESTON
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Credential | ARNP
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Telephone | 360-376-3558
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP30005991
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License Number State | WA
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