Provider Demographics
NPI:1245641406
Name:MCCALL, JEFFREY (PSYD)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:MCCALL
Suffix:
Gender:
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4446 BANNER RD SE
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98366-8846
Mailing Address - Country:US
Mailing Address - Phone:253-241-5237
Mailing Address - Fax:
Practice Address - Street 1:2819 NW KITSAP PL
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-7686
Practice Address - Country:US
Practice Address - Phone:253-241-5237
Practice Address - Fax:360-718-3898
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-09
Last Update Date:2025-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00003626103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist