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General NPI Number Information
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NPI Number | 1922024009
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Entity Type | Individual
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Provider Name | EDYTH DARLENE PHILLIPS M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 07/13/2018
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Provider Practice Location Address
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Address Line | 3200 78TH AVE. S.E.
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City | MERCER ISLAND
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State | WA
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Zip | 98040
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Country | US
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Telephone | 206-232-7218
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Fax | 206-232-8017
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Provider Business Mailing Address
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Address Line | P.O. BOX 2 3200 78TH AVE. S.E.
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City | MERCER ISLAND
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State | WA
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Zip | 98040
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Country | US
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Telephone | 206-232-7218
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Fax | 206-232-8017
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD00009064
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License Number State | WA
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