Provider Demographics
NPI:1366786154
Name:NORTHWEST PSYCHOLOGICAL SERVICES, INC.
Entity type:Organization
Organization Name:NORTHWEST PSYCHOLOGICAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELLIE
Authorized Official - Middle Name:F
Authorized Official - Last Name:STERNQUIST
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:253-851-3141
Mailing Address - Street 1:3309 56TH ST NW
Mailing Address - Street 2:STE 101
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-8572
Mailing Address - Country:US
Mailing Address - Phone:253-851-3141
Mailing Address - Fax:253-851-3155
Practice Address - Street 1:3309 56TH ST NW
Practice Address - Street 2:STE 101
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-8572
Practice Address - Country:US
Practice Address - Phone:253-851-3141
Practice Address - Fax:253-851-3155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-16
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA601426340103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty