Dr Nichole Lynn Mogharreban, PSYD | |
9040 Jackson Ave Madigan Army Medical Center, Tacoma, WA 98431-0001 | |
(253) 968-2252 | |
Not Available |
Full Name | Dr Nichole Lynn Mogharreban |
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Gender | Female |
Speciality | Psychologist - Clinical |
Location | 9040 Jackson Ave Madigan Army Medical Center, Tacoma, Washington |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1013270180 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | 30199 (California) | Secondary |
103TC0700X | Psychologist - Clinical | PY60446879 (Washington) | Primary |
Entity Name | Stanford Health Care |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1437292927 PECOS PAC ID: 6709797491 Enrollment ID: O20031124000348 |
Entity Name | Lpch Medical Group Div Of Lucile |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1417907940 PECOS PAC ID: 0840298543 Enrollment ID: O20061113000232 |
Mailing Address | Practice Location Address |
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Dr Nichole Lynn Mogharreban, PSYD 300 Pasteur Dr, Stanford, CA 94305-2200 Ph: (650) 723-4000 | Dr Nichole Lynn Mogharreban, PSYD 9040 Jackson Ave Madigan Army Medical Center, Tacoma, WA 98431-0001 Ph: (253) 968-2252 |
Dr. Michael Anthony D'angelo Jr., PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: Madigan Army Medical Center 9040 Jackson Ave, Tacoma, WA 98431 Phone: 253-968-5370 | |
Dr. Hillel Samlan, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 9600 Veterans Dr Sw, Tacoma, WA 98493 Phone: 253-583-3591 | |
Dr. Adam Clay Perkins, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 9040 Jackson Ave, Tacoma, WA 98431 Phone: 253-968-3071 | |
Derek Ryan Anderson, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 9600 Veterans Dr Sw, Rehabilitation Care Service (a-117-rcs), Tacoma, WA 98493 Phone: 253-583-1896 | |
Dr. Robin Ferguson, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 9600 Veterans Dr, Tacoma, WA 98493 Phone: 253-582-8440 | |
Dr. Jeremiah Patrick Norris, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 9601 Steilacoom Blvd Sw, Tacoma, WA 98498 Phone: 253-582-8900 Fax: 253-756-2879 |