Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | ||
Y | 103TC0700X | Clinical Psychologist | ||
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist |
NPI | 1003132648 |
---|---|
Provider Name | Phuong My Chau |
First Address | Puyallup, WA 98372-3715 |
Second Address | Puyallup, WA 98372-3715 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2010 |
Last Update Date | 31/08/2015 |