Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | PY60835893 | WA |
NPI | 1083198451 |
---|---|
Provider Name | Dr. Terry Macdonald |
First Address | Everett, WA 98208-6470 |
Second Address | Bothell, WA 98011-8000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2018 |
Last Update Date | 20/09/2018 |