George William Recknagel Jr., PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY00002604 Issued in WA

Practice address

9 Lake Bellevue Dr Ste 217
Bellevue, WA 98005-2454

Phone

(206) 818-4179

Fax

(206) 729-1479

NPI assigned

Aug 18, 2006

Last updated

Dec 13, 2016By the provider in NPPES

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

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481587200000",
    "number": "1114031176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4819 NE 93RD ST",
            "address_2": "P.O. BOX 15153",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981153930",
            "telephone_number": "206-818-4179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 LAKE BELLEVUE DR STE 217",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980052454",
            "telephone_number": "206-818-4179",
            "fax_number": "206-729-1479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RECKNAGEL",
        "first_name": "GEORGE",
        "middle_name": "WILLIAM",
        "name_suffix": "Jr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2016-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY00002604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2016; 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.