MEDICARE: DR. MEREDITH L. GILBERT 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	101YM0800X	Mental Health Counselor	LH00009339	WA
2	103TA0700X	Adult Development & Aging Psychologist	PY00003681	WA
3	103TB0200X	Cognitive & Behavioral Psychologist	PY00003681	WA
4	103TC0700X	Clinical Psychologist	PY00003681	WA
5	103TP2701X	Group Psychotherapy Psychologist	PY00003681	WA

General Provider Information

NPI Number	:	1407055619
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MEREDITH L. GILBERT PH.D.

Provider Business Mailing Address
First Line	:	3035 ISLAND CREST WAY
Second Line	:	SUITE 112
City	:	MERCER ISLAND
State	:	WA
Zip	:	98040-2919
Country	:	US
Telephone Number	:	206-232-2898
Fax Number	:	206-382-0245

Provider Business Practice Location Address
First Line	:	3035 ISLAND CREST WAY
Second Line	:	SUITE 112
City	:	MERCER ISLAND
State	:	WA
Zip	:	98040-2919
Country	:	US
Telephone Number	:	206-232-2898
Fax Number	:	206-382-0245

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

Provider Enumeration Date	:	07/17/2007
Last Update Date	:	07/17/2007

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