Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PY60346724 | WA |
Y | 103T00000X | Psychologist | PY60346724 | WA |
NPI | 1013355262 |
---|---|
Provider Name | Deepa Rao |
First Address | Seattle, WA 98145-5095 |
Second Address | Seattle, WA 98104-2420 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2013 |
Last Update Date | 10/06/2013 |