Provider Demographics
NPI:1528846615
Name:TIMOTHY POPANZ, PHD, PLLC
Entity type:Organization
Organization Name:TIMOTHY POPANZ, PHD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:JON
Authorized Official - Last Name:POPANZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:206-369-6352
Mailing Address - Street 1:2400 NW 80TH ST # 601
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98117-4449
Mailing Address - Country:US
Mailing Address - Phone:206-369-6352
Mailing Address - Fax:
Practice Address - Street 1:8060 23RD AVE NW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98117-4341
Practice Address - Country:US
Practice Address - Phone:206-369-6352
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty