| Organization Name: | PACIFIC PSYCHIATRIC CONSULTING PLLC |
| NPI Number: | 1033374749 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SUPRIYA KANG (OWNER / SOLE PROPRIETOR) |
| Mailing Address: | 24001 56th Ave W Suite D404 Mountlake Terrace |
| State: | WA US |
| Postal Code: | 980435558 |
| Phone Number: | 4257495008 |
| Fax Number: | 8663050497 |
| NPI Enumeration Date: | 07/22/2008 |
| NPI Last Update Date: | 07/22/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM0850X |
| License Number: | MD00047610 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Adult Mental Health |
| Taxonomy Definition: | An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |