Carol Ann Pahlke, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY1687 Issued in WA

Practice address

945 11TH Ave
#B
Longview, WA 98632

Phone

(360) 414-8600

Fax

(360) 636-7372

NPI assigned

Aug 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Northwest Psychological Resources LLC

  • Clinical Neuropsychologist
  • Longview, WA
  • NPI 1811079049
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321401600000",
    "number": "1053422014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "945 11TH AVE",
            "address_2": "#B",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "98632",
            "telephone_number": "360-414-8600",
            "fax_number": "360-636-7372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "945 11TH AVE",
            "address_2": "#B",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "98632",
            "telephone_number": "360-414-8600",
            "fax_number": "360-636-7372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAHLKE",
        "first_name": "CAROL",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2011-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY1687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIMS",
            "identifier": "8921392",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRECARE",
            "identifier": "98632A009",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pacific Psychological Associates
• Pacific Urgent Care LLC -an Oregon LLC
• Cynthia Pack
• Sonya M Packard, BS, CDPT
• William Edward Padden, CPC
• George Palmer, P.T
• Meggan Palmer
• Lydia Pane, DPT
• David Jude Paris, PMHNP-BC
• Andrew Jiho Park I, MA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.