OrganizationActive
Magnolia Psychiatry, LLC
NPI 1003346594 · Addiction Psychiatry Physician · Bellevue, WA
Provider details
- NPI number
- 1003346594
- Entity type
- Organization
- Primary specialty
- Addiction Psychiatry PhysicianAllopathic & Osteopathic Physicians
- Authorized official
- Marc Pellicciaro, Psychiatrist
- License
- MD00036813 (WA)
Practice location
12729 Northup Way Ste 6
Bellevue, WA 98005-1935
Phone: (425) 467-1000
Fax: (425) 467-0100
Mailing address
Po Box 7239
Bellevue, WA 98008-1239
Registry dates
- Enumerated
- 2017-06-15
- Last updated
- 2019-04-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.