Dr Gary Daniel Southwell, PHD is a
Clinical Neuropsychologist based in Olympia, Washington. Dr Gary Daniel Southwell is licensed to practice in Washington (license number PY 60423359) and his current practice location is
9643 39th Loop Ne, Olympia, Washington. He can be reached at his office (for appointments etc.) via phone at
(360) 951-8647.
NPI number for Dr Gary Daniel Southwell is 1538235908 and his current mailing address is 9643 39th Loop Ne, Olympia, Washington. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1538235908.
Healthcare Provider's Profile
| Full Name | Dr Gary Daniel Southwell |
|---|
| Gender | Male |
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| Speciality | Clinical Neuropsychologist |
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| Location | 9643 39th Loop Ne, Olympia, Washington |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1538235908
- Provider Enumeration Date: 11/28/2006
- Last Update Date: 10/31/2016
Medical Identifiers
Medical identifiers for Dr Gary Daniel Southwell such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1538235908 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103TC0700X | Psychologist - Clinical | 1655 (Arizona) | Secondary |
| 103G00000X | Clinical Neuropsychologist | PY 60423359 (Washington) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Gary Daniel Southwell is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Gary Daniel Southwell, PHD
9643 39th Loop Ne,
Olympia, WA 98516-6230
Ph: (360) 951-8647 | Dr Gary Daniel Southwell, PHD
9643 39th Loop Ne,
Olympia, WA 98516-6230
Ph: (360) 951-8647 |
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