Provider Demographics
NPI:1366990251
Name:DHALIWAL, GALE (PHD)
Entity type:Individual
Prefix:
First Name:GALE
Middle Name:
Last Name:DHALIWAL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15600 REDMOND WAY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-3862
Mailing Address - Country:US
Mailing Address - Phone:541-914-0959
Mailing Address - Fax:
Practice Address - Street 1:15600 REDMOND WAY
Practice Address - Street 2:SUITE 201
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3862
Practice Address - Country:US
Practice Address - Phone:541-914-0959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-20
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist