MEDICARE: HEATHER GEBHARDT PH.D.

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	PY60557091	WA

General Provider Information

NPI Number	:	1285002758
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER GEBHARDT PH.D.

Provider Business Mailing Address
First Line	:	6523 CALIFORNIA AVE SW # 187
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98136-1833
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6523 CALIFORNIA AVE SW # 187
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98136-1833
Country	:	US
Telephone Number	:	206-792-9089
Fax Number	:

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

Provider Enumeration Date	:	09/14/2015
Last Update Date	:	02/05/2026

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Directions to “ HEATHER GEBHARDT PH.D.” Practice Location

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