Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 649 | WA |
N | 103TC0700X | Clinical Psychologist | 649 | WA |
N | 102L00000X | Psychologist | 649 | WA |
N | 103T00000X | Psychologist | 649 | WA |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 649 | WA |
N | 103G00000X | Clinical Psychologist | 649 | WA |
N | 103TC0700X | Clinical Psychologist | 649 | WA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 649 | WA |
N | 103TF0200X | Forensic Psychologist | 649 | WA |
N | 103TH0100X | Health Service | 649 | WA |
N | 103TM1800X | Intellectual & Developmental Disabilities | 649 | WA |
N | 103TR0400X | Rehabilitation Psychologist | 649 | WA |
NPI | 1720126980 |
---|---|
Provider Name | Dr. Gayle Lee Fay |
First Address | Bellevue, WA 98004-2953 |
Second Address | Bellevue, WA 98004-2953 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
11569525 | CAQH (01) | WA |