Marissa Ohlstrom, PSYD, PLLC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

MARISSA OHLSTROM, PSYD, PLLC

Practice address

4860 Rainier Avenue S Ste C
Seattle, WA 98118

Phone

(206) 531-4548

NPI assigned

Oct 3, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Marissa Ohlstrom, PSYDNPI 1043775737

Title

Provider/Sole Owner

Phone

(206) 531-4548

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marissa Ohlstrom, PSYD

  • Psychologist
  • Seattle, WA
  • NPI 1043775737
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1664755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666742400000",
    "number": "1053035105",
    "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": {
        "organization_name": "MARISSA OHLSTROM, PSYD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-03",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A",
        "authorized_official_last_name": "OHLSTROM",
        "authorized_official_first_name": "MARISSA",
        "authorized_official_title_or_position": "PROVIDER/SOLE OWNER",
        "authorized_official_telephone_number": "206-531-4548",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ron Wayne Mariotti, ND
• Mariposa Wellness
• Jason E Maris, PA
• Kimberly Tanya Maris, PA-C
• Nathan Lee Maris, MD
• David Mariuma, M.D.
• Mark a. Freeman Jeffrey a. Short PLLC
• Mark C Svore DDS
• Mark David Balter OD, PS
• Mark Ellestad, MD - Psychiatric Services, PLLC

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.