Active NPI
Amy Lundgren, PHD
- Clinical Psychologist
- Seattle, WA
National Provider Identifier
1023188216
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY00003716
- Practice address
- 3512 NE 113TH St
Seattle, WA 98125-5738 - Phone
- (206) 818-8152
- Fax
- (206) 364-0731
- NPI assigned
- Nov 8, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY00003716 | WA | Primary |
Addresses
Primary practice location
3512 NE 113TH St
Seattle, WA 98125-5738
Mailing address
3512 NE 113TH St
Seattle, WA 98125-5738
Phone (206) 818-8152
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 |
|---|---|---|---|
| PY00003716 | WA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263859200000",
"number": "1023188216",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3512 NE 113TH ST",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981255738",
"telephone_number": "206-818-8152",
"fax_number": "206-364-0731"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3512 NE 113TH ST",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981255738",
"telephone_number": "206-818-8152",
"fax_number": "206-364-0731"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUNDGREN",
"first_name": "AMY",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-08",
"last_updated": "2010-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PY00003716",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.