IndividualActive
Charles Bullard, LICSW
NPI 1174736334 · Psychoanalyst · Seattle, WA
Provider details
- NPI number
- 1174736334
- Entity type
- Individual
- Primary specialty
- PsychoanalystBehavioral Health & Social Service Providers
- Credential
- LICSW
- Sex
- Male
- Sole proprietor
- No
- License
- 020704-LW00006183 (WA)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
2206 Queen Anne Ave N
#203
Seattle, WA 98109-2370
Phone: (206) 283-4360
Approximate (ZIP-level) locationGet directions
Mailing address
2206 Queen Anne Ave N
Seattle, WA 98109-2370
Registry dates
- Enumerated
- 2007-05-07
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.