Magnolia Psychiatry, Llc
Addiction Psychiatry Clinic
12729 Northup Way Ste 6, Bellevue
Washington, 98005-1935
425-467-1000 425-467-0100
Maps & DirectionsMagnolia Psychiatry, Llc is a Addiction Psychiatry Clinic in Bellevue, Washington. It is located at 12729 Northup Way Ste 6, Bellevue, WA and its contact number is 425-467-1000. The authorized person for Magnolia Psychiatry, Llc is Marc David Pellicciaro
who is Psychiatrist of the clinic and his/her contact number is 425-467-1000. The primary license number for Magnolia Psychiatry, Llc is MD00036813 (Addiction Psychiatry) in Washington.
Magnolia Psychiatry, Llc Clinic focuses on evaluation and treatment of individuals with alcohol, drug, or other substance-related disorders, and of individuals with dual diagnosis of substance-related and other psychiatric disorders.
Complete Clinic Profile:
Magnolia Psychiatry, Llc Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | Magnolia Psychiatry, Llc |
| Specialization: | Addiction Psychiatry |
| Clinic Address: | 12729 Northup Way Ste 6, Bellevue,
Washington, 98005-1935 |
| Phone: | 425-467-1000 |
| Fax: | 425-467-0100 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
| Name: | Marc David Pellicciaro |
| Position: | Psychiatrist |
| Contact Number: | 425-467-1000 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Magnolia Psychiatry, Llc clinic are as mentioned below.
| NPI Number: | 1003346594 |
| NPI Enumeration Date: | 15 Jun, 2017 |
| NPI Last Update On: | 17 Apr, 2019 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Magnolia Psychiatry, Llc are as mentioned below.
| Specialization | License Number | State | Status | |
| Addiction Psychiatry | MD00036813 | Washington | Primary | |
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| MD00036813 | Other | Washington | Washington State Medical License |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Magnolia Psychiatry, Llc
Po Box 7239,
Bellevue, Washington |
| Zip: | 98008-1239 |
| Phone Number: | 425-467-1000 |
| Fax Number: | 425-467-0100 |
Patients can reach Magnolia Psychiatry, Llc at
12729 Northup Way Ste 6, Bellevue, Washington or can
call to book an appointment on 425-467-1000.
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Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 13 October, 2025.