Marissa Ohlstrom, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

Practice address

4860 Rainier Avenue S Ste C
Seattle, WA 98118

Phone

(206) 531-4548

NPI assigned

Feb 6, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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

Medicare enrollment (NPD)

Enrolled

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.

• Marissa Ohlstrom, PSYD, PLLC

  • Psychologist
  • Seattle, WA
  • NPI 1053035105
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1549411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1043775737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3518 FREMONT AVE N # 325",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981038814",
            "telephone_number": "206-531-4548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4860 RAINIER AVENUE S STE C",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98118",
            "telephone_number": "206-531-4548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OHLSTROM",
        "first_name": "MARISSA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-06",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY60894649",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariah Kaylee Ohle, RN
• Suzanna Marie Ohlsen, MD
• Timothy James Daeeun Ohlsen, MD
• David R. Ohlson, DO
• Andrew J Ohlstrom, MA
• William R Ohlstrom
• Robert Thomas Ohman, MD, MPH
• Sunny Marie Ohman, CRNA
• Eliot Ohringer Gentiluomo
• Jennifer C Ohsie, D.D.S.

• Psychologist in Seattle, WA
• Providers in Seattle, WA by specialty
• Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.