Doctor Name: | DORA SUMMERS-EWING |
NPI Number: | 1124431242 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D |
License Number: | PY00002365 |
Business Practice Address: | 5660 Ne Tolo Rd Bainbridge Island, WA - 981103469 |
Business Phone Number: | 2067808452 |
Business Fax Number: | |
Mailing Address: | 5660 Ne Tolo Rd, BAINBRIDGE ISLAND |
State: | WA |
Postal Code: | 981103469 |
Phone Number: | 2067808452 |
Fax Number: | |
NPI Enumeration Date: | 06/05/2014 |
NPI Last Update Date: | 06/05/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC1900X |
License Number: | PY00002365 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Counseling |
Taxonomy Definition: |