Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | PY00001117 | WA |
NPI | 1063507895 |
---|---|
Provider Name | Dr. Philip Alan Hirsch |
First Address | Shoreline, WA 98155-6139 |
Second Address | Shoreline, WA 98155-6139 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 08/07/2007 |