Provider Demographics
NPI:1992750798
Name:DOOLEY, TOM M (PSYD)
Entity type:Individual
Prefix:
First Name:TOM
Middle Name:M
Last Name:DOOLEY
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 NE CHKALOV DR
Mailing Address - Street 2:STE 123
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684
Mailing Address - Country:US
Mailing Address - Phone:360-513-7398
Mailing Address - Fax:360-260-9777
Practice Address - Street 1:237 NE CHKALOV DR
Practice Address - Street 2:STE 123
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684
Practice Address - Country:US
Practice Address - Phone:360-513-7398
Practice Address - Fax:360-260-9777
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1605103TC0700X
WAPY00002508103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical