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NPI Code Detail

MEDICARE: DR. CHRISTOPHER L STEVENS PHD

MEDICARE: DR. CHRISTOPHER L STEVENS 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
1103TC0700XClinical PsychologistPY60156501WA
2103T00000XPsychologistCA 21900CA

General Provider Information

NPI Number : 1194983015
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHRISTOPHER L STEVENS PHD
Provider Business Mailing Address
First Line : 4425 FREMONT AVE N
Second Line :
City : SEATTLE
State : WA
Zip : 98103-7225
Country : US
Telephone Number : 206-632-7208
Fax Number :
Provider Business Practice Location Address
First Line : 4425 FREMONT AVE N
Second Line :
City : SEATTLE
State : WA
Zip : 98103-7225
Country : US
Telephone Number : 206-632-7208
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2008
Last Update Date : 08/10/2010

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