Active NPI
Darlene E. Walsh-Martin, PHD
- Psychologist
- Medical Lake, WA
National Provider Identifier
1023091329
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PY00001624
- Practice address
- 850 Maple Street
Eastern State Hospital
Medical Lake, WA 99022-0800 - Phone
- (509) 565-4000
- Fax
- (509) 565-4705
- NPI assigned
- Nov 22, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PY00001624 | WA | Primary |
Addresses
Primary practice location
850 Maple Street
Eastern State Hospital
Medical Lake, WA 99022-0800
Mailing address
P.O. Box 800
Eastern State Hosptial
Medical Lake, WA 99022-0800
Phone (509) 565-4000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8388316 | Medicaid | WA |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Department of Social | Past | Accepting new patients | |
| Eastern State Hospital Pharmacy | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Psychiatric Hospital
- Tacoma, WA
- NPI 1144295080
-
- Long Term Care Pharmacy
- Medical Lake, WA
- NPI 1679651970
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1023091329",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 800",
"address_2": "EASTERN STATE HOSPTIAL",
"city": "MEDICAL LAKE",
"state": "WA",
"postal_code": "990220800",
"telephone_number": "509-565-4000",
"fax_number": "509-565-4705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "850 MAPLE STREET",
"address_2": "EASTERN STATE HOSPITAL",
"city": "MEDICAL LAKE",
"state": "WA",
"postal_code": "990220800",
"telephone_number": "509-565-4000",
"fax_number": "509-565-4705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALSH-MARTIN",
"first_name": "DARLENE",
"middle_name": "E.",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-22",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WA",
"license": "PY00001624",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8388316",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Medical Lake, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.