Individual provider Active NPI

Marco Sanchez, M.A. MHP, CDP DVC

  • Clinical Psychologist
  • Seattle, WA
National Provider Identifier
1053441980
Registry record updated Feb 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
17693 Issued in WA
Practice address
1833 N 105TH St Ste 101
Seattle, WA 98133-8973
Phone
(206) 478-1191
Fax
(206) 522-3920
NPI assigned
Mar 7, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 17693 WA Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X WA

Addresses

Primary practice location

1833 N 105TH St Ste 101
Seattle, WA 98133-8973

Mailing address

13527 Densmore Ave N
Seattle, WA 98133-7738
Phone (206) 478-1191

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
Master of Arts

State licenses

LicenseStateTypeSpecialty
17693WAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391644800000",
    "number": "1053441980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13527 DENSMORE AVE N",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981337738",
            "telephone_number": "206-478-1191",
            "fax_number": "206-522-3920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1833 N 105TH ST STE 101",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981338973",
            "telephone_number": "206-478-1191",
            "fax_number": "206-522-3920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANCHEZ",
        "first_name": "MARCO",
        "name_prefix": "Mr.",
        "credential": "M.A. MHP, CDP DVC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2014-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "17693",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": null,
            "primary": false
        }
    ],
    "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 Feb 6, 2014; 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.