Individual provider Active NPI

Walter Scott Mabee, PHD

  • Psychologist
  • Spokane, WA
National Provider Identifier
1083700694
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1119 Issued in WA
Practice address
905 West Riverside Avenue
Suite 610
Spokane, WA 99201-1099
Phone
(509) 742-3460
Fax
(509) 742-3461
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1119 WA Primary

Addresses

Primary practice location

905 West Riverside Avenue
Suite 610
Spokane, WA 99201-1099

Mailing address

905 West Riverside Avenue
Suite 610
Spokane, WA 99201-1099
Phone (509) 742-3460

Other identifiers 3

IdentifierTypeStateIssuer
7015662MedicaidWA
45626OtherWADLI
8057938MedicaidID

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

LicenseStateTypeSpecialty
1119WAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083700694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 WEST RIVERSIDE AVENUE",
            "address_2": "SUITE 610",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992011099",
            "telephone_number": "509-742-3460",
            "fax_number": "509-742-3461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 WEST RIVERSIDE AVENUE",
            "address_2": "SUITE 610",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992011099",
            "telephone_number": "509-742-3460",
            "fax_number": "509-742-3461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MABEE",
        "first_name": "WALTER",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "1119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7015662",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DLI",
            "identifier": "45626",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8057938",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.