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NPI Code Detail

MEDICARE: DR. ROBERTA H DEVINE PHD

MEDICARE:  DR. ROBERTA H DEVINE  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
1103T00000XPsychologistPY00001516WA

General Provider Information

NPI Number : 1174648679
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERTA H DEVINE PHD
Provider Business Mailing Address
First Line : 2568 4TH AVE W STE A
Second Line :
City : SEATTLE
State : WA
Zip : 98119-2370
Country : US
Telephone Number : 206-378-0599
Fax Number :
Provider Business Practice Location Address
First Line : 2568 4TH AVE W STE A
Second Line :
City : SEATTLE
State : WA
Zip : 98119-2370
Country : US
Telephone Number : 206-378-0599
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2007
Last Update Date : 05/04/2022

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Directions to “ DR. ROBERTA H DEVINE PHD” Practice Location

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