Provider Demographics
NPI:1871787374
Name:STROUP, DAVID M (PHD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:STROUP
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1037 NE 65TH ST
Mailing Address - Street 2:SUITE #345
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-6655
Mailing Address - Country:US
Mailing Address - Phone:206-395-9301
Mailing Address - Fax:309-406-6366
Practice Address - Street 1:1700 NW GILMAN BLVD
Practice Address - Street 2:SUITE #205
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-5349
Practice Address - Country:US
Practice Address - Phone:206-395-9301
Practice Address - Fax:309-406-6366
Is Sole Proprietor?:No
Enumeration Date:2007-08-29
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WA60128042103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical