Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 1300 | WA |
N | 103TC0700X | Clinical Psychologist | 1300 | WA |
Y | 103G00000X | Clinical Psychologist | 1300 | WA |
Y | 103TC0700X | Clinical Psychologist | 1300 | WA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 1300 | WA |
NPI | 1043331226 |
---|---|
Provider Name | Dr. James Edwin Mckeever |
First Address | Bainbridge Island, WA 98110-2860 |
Second Address | Bainbridge Island, WA 98110-2860 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2007 |
Last Update Date | 23/03/2010 |