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General NPI Number Information
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NPI Number | 1922112937
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Entity Type | Individual
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Provider Name | DIANE M ADAMS PH.D.
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Gender | Female
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 05/22/2020
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Provider Practice Location Address
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Address Line | 1412 SW 43RD ST STE 240
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City | RENTON
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State | WA
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Zip | 98057-4803
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Country | US
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Telephone | 253-852-4699
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Fax | 844-848-1265
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Provider Business Mailing Address
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Address Line | 19012 103RD PL SE
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City | RENTON
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State | WA
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Zip | 98055-6602
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Country | US
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Telephone | 253-852-4699
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Fax | 844-848-1265
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY203189
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PS00002393
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License Number State | WA
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