institution
Vivid Psychiatry Llc
Psychiatric/Mental Health Nurse Practitioner in Maple Valley, Washington
NPI 1336613553

Vivid Psychiatry Llc is a Psychiatric/Mental Health Nurse Practitioner based in Covington, WA and is specialized in Psychiatric/Mental Health. Vivid Psychiatry Llc practices in Maple Valley, WA. The NPI Number for Vivid Psychiatry Llc is 1336613553 and holds a License No. (Washington).

The current practice location address for Vivid Psychiatry Llc is 22443 Se 240Th St Ste 202, Maple Valley, WA and can be reached out via phone at 937-479-3406 and via fax at 877-894-5104.

Location: 22443 Se 240Th St Ste 202, Maple Valley, WA, 98042-6156
institution
Provider Profile Details
NPI Number
1336613553
Provider Name
Vivid Psychiatry Llc
Credential
Provider Entity Type
Organization
Address
22443 Se 240Th St Ste 202, Maple Valley, WA, 98042-6156
Phone Number
937-479-3406
Fax Number
877-894-5104
Provider Enumeration Date
01/22/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
AP60729876 01 WA LICENSE
institution
Provider Business Practice Location Address Details
Address
22443 Se 240Th St Ste 202
City
State
Zip
98038-5879
Phone Number
937-479-3406
Fax Number
877-894-5104
person
Provider Business Mailing Address Details
Address
22443 Se 240Th St Ste 202
City
State
Zip
98038-5879
Phone Number
937-479-3406
Fax Number
877-894-5104
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
License No.
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Definition
Definition to come...
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