| Phd#2 Of Snohomish County | |
|
21601 76th Ave W Edmonds WA 98026-7507 | |
| (425) 640-4000 | |
| (425) 640-4432 |
| Full Name | Phd#2 Of Snohomish County |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 21601 76th Ave W, Edmonds, Washington |
| Authorized Official Name and Position | Gary Wangsmo (CFO) |
| Authorized Official Contact | 4256404113 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Phd#2 Of Snohomish County 21601 76th Ave W Edmonds WA 98026-7507 Ph: (425) 640-4000 | Phd#2 Of Snohomish County 21601 76th Ave W Edmonds WA 98026-7507 Ph: (425) 640-4000 |
| NPI Number | 1023006061 |
|---|---|
| Provider Enumeration Date | 10/13/2005 |
| Last Update Date | 08/28/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023006061 | NPI | - | NPPES |
| W718582 | Other | WA | CHAMPUS |
| MC150 | Other | WA | PREMERA BLUE CROSS |
| ST0092 | Other | WA | REGENCE BLUE SHIELD |
| 150 | Other | WA | PREMERA BLUE CROSS |
| 11031 | Other | WA | WA DEPT OF L&I |
| 0288 | Other | WA | REGENCE BLUE SHIELD |
| 3500071 | Medicaid | WA | |
| HP150 | Other | WA | PREMERA BLUE CROSS |
| 0065668 | Other | WA | AETNA |
| 6580520 | Other | WA | AETNA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | H-138 (Washington) | Primary |
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