NPI 1003346594

Magnolia Psychiatry, LLC

Organisation Addiction Psychiatry Physician Bellevue, WA

Practice location

Address: 12729 Northup Way STE 6, Bellevue, WA 98005-1935
Phone: (425) 467-1000
Fax: (425) 467-0100
Mailing address: PO Box 7239, Bellevue, WA 98008-1239

Authorised official

Name: Marc David Pellicciaro
Title: Psychiatrist
Phone: (425) 467-1000

Registered specialties

Addiction Psychiatry Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2084P0802X Licence MD00036813 (WA)

Other Psychiatry & Neurology providers in Washington →

Registry record

NPI: 1003346594
Entity type: Organization
NPI issued: 15 Jun 2017
Record last updated: 17 Apr 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.