Search › Washington › 103T00000X
Fredric Provenzano, PH.D
NPI 1700932696 · on the registry since 2007 · sole proprietor
Practice
- Address
- 5506 33rd Ave Ne
Suite D
Seattle, WA 98105 - Phone
- (206) 361-2343
- Fax
- (206) 361-0353
- Clinicians at this address
- 3
Registry record
- Primary taxonomy
- 103T00000X
103T00000X
- Licence states on file
- WA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2007-07-08
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Washington