Phillip S Tate, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PY60232335 Issued in WA

Practice address

12303 Meridian E Ste 202
Puyallup, WA 98373-3418

Phone

(253) 268-0854

Fax

(253) 268-0854

NPI assigned

Nov 30, 2011

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Texas Tech University Health Science Center School of Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Phillip S. Tate PHD, PLLC

  • Clinical Psychologist
  • Puyallup, WA
  • NPI 1942018866
  Medicare reassignment NPD Authorized official
• Advanced Behavioral Medicine and Neuropsychology Associates, PLLC

  • Clinical Neuropsychologist
  • Tacoma, WA
  • NPI 1558372268
  NPD
• Advanced Behavioral Medicine

  • Specialist
  • Tacoma, WA
  • NPI 1578964367
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1322611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1023385366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12303 MERIDIAN E STE 202",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983733418",
            "telephone_number": "253-268-0854",
            "fax_number": "253-268-0854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12303 MERIDIAN E STE 202",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983733418",
            "telephone_number": "253-268-0854",
            "fax_number": "253-268-0854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATE",
        "first_name": "PHILLIP",
        "middle_name": "S",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-30",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "WA",
            "license": "PY60232335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan Jo Tan, MD
• Jazmyn Princess Carroll Tang, ARNP
• Joslyn A Tapec, ARNP
• Anahi Tapia Diaz
• Lea Tate, LSWAIC
• Luis M Taveras, M.D.
• Ruba H Tawil, DDS
• Alan F Taylor
• Allysa J Taylor, LMT
• Charles Lee Taylor

• Clinical Neuropsychologist in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Clinical Neuropsychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.