Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | ||
Y | 103G00000X | Clinical Psychologist | PY00003296 | WA |
Y | 103TC0700X | Clinical Psychologist | PY00003296 | WA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist |
NPI | 1225216716 |
---|---|
Provider Name | Dr. Stacy Shaw Welch |
First Address | Seattle, WA 98101-3097 |
Second Address | Seattle, WA 98101-3097 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2008 |
Last Update Date | 06/02/2008 |