Travis Dylan Dennison, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY61163194 Issued in WA

Practice address

2420 S Union Ave Ste 100
Tacoma, WA 98405-1306

Phone

(253) 752-7320

NPI assigned

Nov 19, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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.

• Sea Mar Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Gig Harbor, WA
  • NPI 1578127411
  NPD (past)

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

{
    "created_epoch": "1637280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1104583608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4806 N 13TH ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984063204",
            "telephone_number": "206-909-1320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 S UNION AVE STE 100",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984051306",
            "telephone_number": "253-752-7320"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3208 50th St Ct NW Ste 202",
            "address_purpose": "LOCATION",
            "city": "Gig Harbor",
            "state": "WA",
            "postal_code": "983358583",
            "country_code": "US",
            "telephone_number": "253-280-9888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DENNISON",
        "first_name": "TRAVIS",
        "middle_name": "DYLAN",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-19",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY61163194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Denney
• Cory Daniel Dennis, LMP
• Jamila Nandi Dennis
• Wendy Naomi Dennis
• Kyle Donald Dennison, PSYD
• Robert Denslow, DMD
• Chapin Densmore, DDS
• Dent Korsmo & Henry D.D.S., P.S.
• Gregory Eugene Dent, DDS
• Dental Professionals of Washington, Quirt, Mongrain, Gibree, PC

• Clinical Psychologist in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.