Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | 33780981 | WA |
NPI | 1174915151 |
---|---|
Provider Name | Gail Fahey |
First Address | Vancouver, WA 98661-3713 |
Second Address | Vancouver, WA 98661-3713 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2015 |
Last Update Date | 14/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1174915151 | PATHOLOGY (01) | WA |
140-239 | ICD-9-CM (01) | WA |
390-459 | ICD-9CM (01) | WA |
680-709 | ICD-9CM (01) | WA |
740-759 | ICD-9CM (01) | WA |
C100, C200, C300 | COUNSELING (01) | WA |
C400 | COUNSELING (01) | WA |
CEDC | EMERGENCY DEPARTMENT (01) | WA |
CEMC | EVALUATION AND MANAGEMENT (01) | WA |
CFPC | FAMILY PRACTICE (01) | WA |
CHONC | HEMATOLOGY AND ONCOLOGY (01) | WA |
CIMC | INTERNAL MEDICINE (01) | WA |
L100, L300, A100 | CASE ASSESSMENT, DEVELOPMENT, AND ADMINISTRATION (01) | WA |
P100, P300 | STRUCTURE, STRATEGY, ANALYSIS (01) | WA |
T1015 | CLINIC SERVICE (01) | WA |