Provider Demographics
NPI:1053431767
Name:HALE, NATALIE (PHD)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:HALE
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 1:1300 114TH AVE SE STE 115
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-6928
Mailing Address - Country:US
Mailing Address - Phone:425-462-9511
Mailing Address - Fax:425-462-8894
Practice Address - Street 1:1300 114TH AVE SE STE 115
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-6928
Practice Address - Country:US
Practice Address - Phone:425-462-9511
Practice Address - Fax:425-462-8894
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY60536428103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO497440206Medicaid