Active NPI
Jared Newman Kilmer, PHD
- Clinical Psychologist
- Kirkland, WA
National Provider Identifier
1003435694
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 60963309
- Practice address
- 12025 115TH Ave NE Ste 215
Kirkland, WA 98034-6943 - Phone
- (425) 405-5316
- NPI assigned
- Apr 13, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 60963309 | WA | Primary |
| Clinical Psychologist | 103TC0700X | 37976 | TX |
Addresses
Primary practice location
12025 115TH Ave NE Ste 215
Kirkland, WA 98034-6943
Mailing address
12025 115TH Ave NE
Building D Ste 215
Kirkland, WA 98034-7304
Phone (425) 222-2599
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60963309 | WA | MD | Clinical Psychologist |
| 37976 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621296000000",
"number": "1003435694",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12025 115TH AVE NE",
"address_2": "BUILDING D STE 215",
"city": "KIRKLAND",
"state": "WA",
"postal_code": "980347304",
"telephone_number": "425-222-2599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12025 115TH AVE NE STE 215",
"city": "KIRKLAND",
"state": "WA",
"postal_code": "980346943",
"telephone_number": "425-405-5316"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KILMER",
"first_name": "JARED",
"middle_name": "NEWMAN",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-04-13",
"last_updated": "2021-05-18",
"certification_date": "2021-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "60963309",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "37976",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kirkland, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.