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NPI Code Detail

MEDICARE: JAMES LOLLEY PSYD

MEDICARE:   JAMES  LOLLEY  PSYD
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 PsychologistPY60345764WA

General Provider Information

NPI Number : 1427474618
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES LOLLEY PSYD
Provider Business Mailing Address
First Line : 509 OLIVE WAY STE 204
Second Line :
City : SEATTLE
State : WA
Zip : 98101-1726
Country : US
Telephone Number : 206-329-5255
Fax Number :
Provider Business Practice Location Address
First Line : 509 OLIVE WAY STE 204
Second Line :
City : SEATTLE
State : WA
Zip : 98101-1726
Country : US
Telephone Number : 206-329-5255
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2014
Last Update Date : 05/11/2017

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Directions to “ JAMES LOLLEY PSYD” Practice Location

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