MEDICARE: DR. ALBERT B PAIGE PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PY247	WA

General Provider Information

NPI Number	:	1053302539
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALBERT B PAIGE PHD

Provider Business Mailing Address
First Line	:	13436 NE 47TH ST
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98005-1112
Country	:	US
Telephone Number	:	425-885-6444
Fax Number	:	425-881-7767

Provider Business Practice Location Address
First Line	:	1001 BROADWAY
Second Line	:	STE 318
City	:	SEATTLE
State	:	WA
Zip	:	98122-4397
Country	:	US
Telephone Number	:	206-726-0174
Fax Number	:	425-881-7767

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	07/08/2007

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