| Crestview Psychological Services, P.s. | |
|
1610 Grover St Suite D-1 Lynden WA 98264-1539 | |
| (360) 398-8217 | |
| (360) 354-5399 |
| Full Name | Crestview Psychological Services, P.s. |
|---|---|
| Speciality | Psychologist |
| Location | 1610 Grover St, Lynden, Washington |
| Authorized Official Name and Position | Daniel Dale Brinkman (PRESIDENT) |
| Authorized Official Contact | 3603988127 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crestview Psychological Services, P.s. Po Box 331 Lynden WA 98264-0331 Ph: (360) 398-8127 | Crestview Psychological Services, P.s. 1610 Grover St Suite D-1 Lynden WA 98264-1539 Ph: (360) 398-8217 |
| NPI Number | 1992782015 |
|---|---|
| Provider Enumeration Date | 12/29/2005 |
| Last Update Date | 04/21/2022 |
| Certification Date | 04/21/2022 |
| Medicare PECOS PAC ID | 1355365503 |
|---|---|
| Medicare Enrollment ID | O20060116000164 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992782015 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY00001993 (Washington) | Primary |
| Provider Name | Daniel D Brinkman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1265588255 PECOS PAC ID: 6507887981 Enrollment ID: I20051213000567 |
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