| Bluestone Psychological Services, Llc | |
|
7522 221st Pl Sw Edmonds WA 98026-8029 | |
| (425) 775-4059 | |
| (425) 775-7210 |
| Full Name | Bluestone Psychological Services, Llc |
|---|---|
| Speciality | Counselor |
| Location | 7522 221st Pl Sw, Edmonds, Washington |
| Authorized Official Name and Position | Julie Ann Hanson (MEMBER/MANAGER) |
| Authorized Official Contact | 4257754059 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bluestone Psychological Services, Llc 7522 221st Pl Sw Edmonds WA 98026-8029 Ph: (425) 775-4059 | Bluestone Psychological Services, Llc 7522 221st Pl Sw Edmonds WA 98026-8029 Ph: (425) 775-4059 |
| NPI Number | 1811269624 |
|---|---|
| Provider Enumeration Date | 02/08/2012 |
| Last Update Date | 06/03/2024 |
| Certification Date | 06/03/2024 |
| Medicare PECOS PAC ID | 6305174806 |
|---|---|
| Medicare Enrollment ID | O20190821004511 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811269624 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | LH00005434 (Washington) | Primary |
| Provider Name | Teresa Haaga |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831311604 PECOS PAC ID: 5698869386 Enrollment ID: I20070926000401 |
| Provider Name | Megan C Merriwether |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1225209190 PECOS PAC ID: 8325116510 Enrollment ID: I20080930000808 |
| Provider Name | Cherrie Ann Palmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801342795 PECOS PAC ID: 1355638198 Enrollment ID: I20160922001634 |
| Provider Name | William J Roedel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356648794 PECOS PAC ID: 4587992094 Enrollment ID: I20230120002149 |
| Provider Name | Susan Bomalaski |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447644679 PECOS PAC ID: 2668824541 Enrollment ID: I20240116003232 |
| Provider Name | Christine A Vervitsiotis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366016313 PECOS PAC ID: 1254774235 Enrollment ID: I20240206004563 |
| Provider Name | Doralissa R. Griffin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457654741 PECOS PAC ID: 0941645782 Enrollment ID: I20240301003536 |
| Provider Name | Amber Leigh Donaldson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841354396 PECOS PAC ID: 2163867946 Enrollment ID: I20240303000171 |
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