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MAGNOLIA PSYCHIATRY, LLC
NPI 1003346594
Psychiatry & Neurology - Addiction Psychiatry in Bellevue, WA

Active since June 15, 2017
12729 NORTHUP WAY STE 6, BELLEVUE, WA 98005(425) 467-1000(425) 467-0100 Get Directions Write a Review

NPPES record last updated: April 17, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 17, 2019, Jun 15, 2017 (2 updates tracked since 2017).

About Magnolia Psychiatry, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MAGNOLIA PSYCHIATRY, LLC (NPI 1003346594) is a healthcare organization registered as an addiction psychiatry in Bellevue, Washington and active in the NPI registry since June 2017. The organization lists Marc David Pellicciaro, Psychiatrist, as its authorized official.

NPPES Registry Identity

NPI1003346594
Entity TypeOrganization
Primary Taxonomy2084P0802X
Legal Business NameMAGNOLIA PSYCHIATRY, LLC
Location Address12729 NORTHUP WAY STE 6Bellevue, WA 98005-1935
Mailing AddressPo Box 7239Bellevue, WA 98008-1239 · (425) 467-1000 · Fax (425) 467-0100
Phone(425) 467-1000
Fax(425) 467-0100
Organization SubpartNo
Authorized OfficialMarc David PellicciaroPsychiatrist · (425) 467-1000
Enumeration DateJune 15, 2017
Last NPPES UpdateApril 17, 20192 updates tracked since enumeration
✔ NPI 1003346594 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · Addiction PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0802X
License✔ Licensed in WA · MD00036813
Definition
Addiction Psychiatry is a subspecialty of psychiatry that 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.
12729 NORTHUP WAY STE 6, Bellevue, WA 98005
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Other Identifiers 1

OtherMD00036813WA · Washington State Medical License

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska.Insurance ›

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MARC D PELLICCIARO M.D.
Psychiatry & Neurology (Addiction Medicine)
12729 NORTHUP WAY STE 6
BELLEVUE, WA 98005
King County (425) 467-1000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Magnolia Psychiatry, LLC's NPI number?

The NPI number for Magnolia Psychiatry, LLC is 1003346594. It was assigned to this organization in the NPPES registry on June 15, 2017.

Where is Magnolia Psychiatry, LLC located?

Magnolia Psychiatry, LLC is located at 12729 Northup Way Ste 6, Bellevue, WA 98005. The listed phone number is (425) 467-1000.

What is Magnolia Psychiatry, LLC's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Addiction Psychiatry, with taxonomy code 2084P0802X.

What insurance does Magnolia Psychiatry, LLC accept?

Health plans from Premera Blue Cross Blue Shield of Alaska list Magnolia Psychiatry, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Magnolia Psychiatry, LLC was last updated on April 17, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.