Active NPI
Jonathan B. Wulf, PSYD
- Clinical Psychologist
- Seattle, WA
National Provider Identifier
1063583060
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective May 18, 2017.
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY00002329
- Practice address
- 1401 Madison St Ste 100
Seattle, WA 98104-1316 - Phone
- (206) 386-6111
- Fax
- (206) 386-6113
- NPI assigned
- Nov 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY00002329 | WA | Primary |
Addresses
Primary practice location
1401 Madison St Ste 100
Seattle, WA 98104-1316
Mailing address
PO Box 84026
Seattle, WA 98124-8426
Phone (206) 386-6111
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8400772 | Medicaid | WA |
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1234828800000",
"number": "1063583060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 84026",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981248426",
"telephone_number": "206-386-6111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 MADISON ST STE 100",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981041316",
"telephone_number": "206-386-6111",
"fax_number": "206-386-6113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WULF",
"first_name": "JONATHAN",
"middle_name": "B.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-13",
"last_updated": "2009-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PY00002329",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8400772",
"state": "WA"
}
],
"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 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.