Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 60922796 | WA |
Y | 103TC0700X | Clinical Psychologist | 60922796 | WA |
NPI | 1003464868 |
---|---|
Provider Name | Alice Verstaen |
First Address | Seattle, WA 98108-1565 |
Second Address | Seattle, WA 98108-1565 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2019 |
Last Update Date | 26/08/2019 |