Provider Demographics
NPI:1104058692
Name:SLAUGHTER, SAMANTHA LEA (PSYD)
Entity type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:LEA
Last Name:SLAUGHTER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3429 FREMONT AVE N STE 317
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-8811
Mailing Address - Country:US
Mailing Address - Phone:206-300-2452
Mailing Address - Fax:206-567-1212
Practice Address - Street 1:3429 FREMONT AVE N STE 317
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-8811
Practice Address - Country:US
Practice Address - Phone:206-300-2452
Practice Address - Fax:206-567-1212
Is Sole Proprietor?:No
Enumeration Date:2009-08-17
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY60075756103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical