Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Magnolia Psychiatry, LLC

Organization Addiction Psychiatry Physician · NPI 1003346594

Magnolia Psychiatry, LLC is an Addiction Psychiatry Physician in Bellevue, Washington. Licensed in Washington. Registered with an NPI since 2017.

Licensed in
WA
In the registry since
2017
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

12729 Northup Way Ste 6
Bellevue, WA 98005-1935
Phone: (425) 467-1000
Fax: (425) 467-0100
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction Psychiatry Physician (primary) Taxonomy 2084P0802X · Licence MD00036813 (WA)

Record details

NPI number1003346594
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Marc Pellicciaro — Psychiatrist · (425) 467-1000
NPI enumeratedJune 15, 2017
Last updated in NPPESApril 17, 2019
Mailing addressPo Box 7239, Bellevue, WA 98008-1239

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