Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PY61117378 | WA |
Y | 103TC0700X | Clinical Psychologist | PY61117378 | WA |
NPI | 1003485327 |
---|---|
Provider Name | Dr. Trevor N Coyle |
First Address | Seattle, WA 98115-7982 |
Second Address | Honolulu, HI 96819-1522 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2021 |
Last Update Date | 21/06/2021 |