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NPI Code Detail

MEDICARE: SAMUEL COLLIER PSYD

MEDICARE: SAMUEL COLLIER 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 PsychologistPY61040015WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1831628031
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMUEL COLLIER PSYD
Provider Business Mailing Address
First Line : 3515 SW ALASKA ST
Second Line :
City : SEATTLE
State : WA
Zip : 98126-2730
Country : US
Telephone Number : 206-979-8787
Fax Number :
Provider Business Practice Location Address
First Line : 3515 SW ALASKA ST
Second Line :
City : SEATTLE
State : WA
Zip : 98126-2730
Country : US
Telephone Number : 253-234-7226
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2017
Last Update Date : 01/31/2022

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Directions to “ SAMUEL COLLIER PSYD” Practice Location

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