1457720351 NPI number — HOPE PSYCHOLOGY & ASSESSMENTS

Table of content: (NPI 1457720351)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457720351 NPI number — HOPE PSYCHOLOGY & ASSESSMENTS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOPE PSYCHOLOGY & ASSESSMENTS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
KATHERINE J. KELLY, PH.D.
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1457720351
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/21/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
707 S GRADY WAY
Provider Second Line Business Mailing Address:
#600
Provider Business Mailing Address City Name:
RENTON
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98057-3224
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
425-757-2920
Provider Business Mailing Address Fax Number:
425-207-7425

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
707 S GRADY WAY
Provider Second Line Business Practice Location Address:
#600
Provider Business Practice Location Address City Name:
RENTON
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98057-3224
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-757-2920
Provider Business Practice Location Address Fax Number:
425-757-2920
Provider Enumeration Date:
09/21/2015

Additional Information

Authorized Official

Authorized Official Last Name:
KELLY
Authorized Official First Name:
KATHERINE
Authorized Official Middle Name:
JANE
Authorized Official Title or Position:
PSYCHOLOGIST
Authorized Official Telephone Number:
425-757-2920

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  PY 60563485 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1841483286 . This is a "NPI" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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