| Seatac Senior Psychology Llc | |
|
9340 Ne 76th St Vancouver WA 98662-3721 | |
| (360) 253-4912 | |
| (360) 253-5170 |
| Full Name | Seatac Senior Psychology Llc |
|---|---|
| Speciality | Psychologist |
| Location | 9340 Ne 76th St, Vancouver, Washington |
| Authorized Official Name and Position | David W Agnor (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3602534912 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Seatac Senior Psychology Llc 9340 Ne 76th St Vancouver WA 98662-3721 Ph: (360) 253-4912 | Seatac Senior Psychology Llc 9340 Ne 76th St Vancouver WA 98662-3721 Ph: (360) 253-4912 |
| NPI Number | 1831326834 |
|---|---|
| Provider Enumeration Date | 06/17/2009 |
| Last Update Date | 06/17/2009 |
| Medicare PECOS PAC ID | 7719032226 |
|---|---|
| Medicare Enrollment ID | O20090908000132 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831326834 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY00001983 (Washington) | Primary |
| Provider Name | Melvin Gerald Watt |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1821055096 PECOS PAC ID: 1355334681 Enrollment ID: I20040405000445 |
| Provider Name | Anthony L Delbert |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437105244 PECOS PAC ID: 7416922935 Enrollment ID: I20040830000033 |
| Provider Name | Vanya E Sandberg |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1891014668 PECOS PAC ID: 1153453725 Enrollment ID: I20100716000496 |
| Provider Name | Mary A Kenney |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1083906515 PECOS PAC ID: 4688828643 Enrollment ID: I20130129000449 |
| Provider Name | Mary Jo Moeschl |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1417365982 PECOS PAC ID: 1355664251 Enrollment ID: I20150102001517 |
| Provider Name | Anna C Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1578883013 PECOS PAC ID: 1355644972 Enrollment ID: I20160114001522 |
| Provider Name | Rosemary Irene Piper |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1265565964 PECOS PAC ID: 5092010819 Enrollment ID: I20160216001690 |
| Provider Name | Nancy Bell Corbin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1750739595 PECOS PAC ID: 2567755275 Enrollment ID: I20160718002235 |
| Provider Name | Theodore G Sneed |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790862001 PECOS PAC ID: 0648378182 Enrollment ID: I20160803002248 |
| Provider Name | Larry G Knauss |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1073670055 PECOS PAC ID: 1557657822 Enrollment ID: I20160913001105 |
| Provider Name | Sneha L. A. Mcclincey |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396075495 PECOS PAC ID: 9830446731 Enrollment ID: I20180724001975 |
| Provider Name | Haley Elizabeth Miller |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1548666209 PECOS PAC ID: 1153695309 Enrollment ID: I20180912003337 |
| Provider Name | Carol Lee Tyler |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881715464 PECOS PAC ID: 8123351871 Enrollment ID: I20190611003608 |
| Provider Name | Sherry Lee Spurling |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1407250178 PECOS PAC ID: 6709854193 Enrollment ID: I20190729002535 |
| Provider Name | Melinda Louise Bale |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184173023 PECOS PAC ID: 6507195682 Enrollment ID: I20190916001454 |
| Provider Name | Yuliya Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184257289 PECOS PAC ID: 7719316538 Enrollment ID: I20200330003938 |
| Provider Name | David Ross |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1477655454 PECOS PAC ID: 1557330925 Enrollment ID: I20201231001343 |
| Provider Name | Katrina B Kwan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760727580 PECOS PAC ID: 1052565728 Enrollment ID: I20211216001020 |
| Provider Name | Susan Elizabeth Brogan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1346499795 PECOS PAC ID: 2567512981 Enrollment ID: I20220418000535 |
| Provider Name | Talia Sue Cronk |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1548975717 PECOS PAC ID: 3476925314 Enrollment ID: I20230202001320 |
| Provider Name | Mary Blaine Atwater |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386303048 PECOS PAC ID: 5991141152 Enrollment ID: I20240311000082 |
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