Provider Demographics
NPI:1962691345
Name:EARLY, EMMETT MICHAEL (PHD)
Entity type:Individual
Prefix:DR
First Name:EMMETT
Middle Name:MICHAEL
Last Name:EARLY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4719 UNIVERSITY WAY NE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-4400
Mailing Address - Country:US
Mailing Address - Phone:206-527-4684
Mailing Address - Fax:
Practice Address - Street 1:4719 UNIVERSITY WAY NE
Practice Address - Street 2:SUITE 206
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-4400
Practice Address - Country:US
Practice Address - Phone:206-527-4684
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-22
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA603103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist