Otis Edd Payne, M.D.,ps
Psychiatry & Neurology, Psychiatry in Lake Forest Park, WA. Organization (NPI-2).
NPI number1073705166
StatusActive
Last updated in NPPESAug 13, 2007
Details
- NPI
- 1073705166
- Entity type
- Organization (NPI-2)
- Legal business name
- Otis Edd Payne, M.D.,ps
- Organization subpart
- No
- Enumeration date
- Aug 13, 2007
- Last updated
- Aug 13, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology, Psychiatry | MD00010587 | WA | Yes |
Practice location
18015 53rd Ave NeLake Forest Park, WA 98155-4361
Phone 206-427-2171 · Fax 425-670-8293
Mailing address
18015 53rd Ave NeLake Forest Park, WA 98155-4361
Phone 206-427-2171 · Fax 425-670-8293
Authorized official
Otis Edd Payne
President
2064272171
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