Provider Demographics
NPI:1699068189
Name:MCGREGOR, BONNIE A (PHD)
Entity type:Individual
Prefix:DR
First Name:BONNIE
Middle Name:A
Last Name:MCGREGOR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6522 FREMONT AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-5358
Mailing Address - Country:US
Mailing Address - Phone:206-349-2421
Mailing Address - Fax:
Practice Address - Street 1:6306 PHINNEY AVE N
Practice Address - Street 2:SUITE1
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-5559
Practice Address - Country:US
Practice Address - Phone:206-349-2421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-17
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00002730103TH0004X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical