Active NPI
Donna May Lidren, PHD
- Health Service Psychologist
- Tacoma, WA
National Provider Identifier
1073534079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Service Psychologist
- License
- PY00001859
- Practice address
- 2013 So 19TH St
Tacoma, WA 98405 - Phone
- (253) 383-3355
- Fax
- (253) 383-3627
- NPI assigned
- Jul 22, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY00001859 | WA | |
| Health Service Psychologist | 103TH0100X | PY00001859 | WA | Primary |
| Psychologist | 103T00000X | PY00001859 | WA |
Addresses
Primary practice location
2013 So 19TH St
Tacoma, WA 98405
Mailing address
2013 So 19TH St
Tacoma, WA 98405
Phone (253) 383-3355
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0076471 | Other | WA | DEPT OF L&I |
| LI0788 | Other | WA | REGENCE BS |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY00001859 | WA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Behavioral Medicine | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Specialist
- Tacoma, WA
- NPI 1578964367
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1073534079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2013 SO 19TH ST",
"city": "TACOMA",
"state": "WA",
"postal_code": "98405",
"telephone_number": "253-383-3355",
"fax_number": "253-383-3627"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2013 SO 19TH ST",
"city": "TACOMA",
"state": "WA",
"postal_code": "98405",
"telephone_number": "253-383-3355",
"fax_number": "253-383-3627"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIDREN",
"first_name": "DONNA",
"middle_name": "MAY",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-22",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PY00001859",
"primary": false
},
{
"code": "103TH0100X",
"taxonomy_group": "",
"desc": "Psychologist, Health Service",
"state": "WA",
"license": "PY00001859",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WA",
"license": "PY00001859",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT OF L&I",
"identifier": "0076471",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BS",
"identifier": "LI0788",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.