Individual provider Active NPI

Stephanie Ann Wright

  • Psychologist
  • Seattle, WA
National Provider Identifier
1124422464
Registry record updated Oct 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY60736580 Issued in WA
Practice address
1417 NW 54TH St Ste 215
Seattle, WA 98107-3572
Phone
(206) 929-9749
Fax
(206) 681-9996
NPI assigned
Oct 15, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY60736580 WA Primary

Addresses

Primary practice location

1417 NW 54TH St Ste 215
Seattle, WA 98107-3572

Mailing address

1417 NW 54TH St Ste 215
Seattle, WA 98107-3572
Phone (206) 929-9749

Other identifiers 1

IdentifierTypeStateIssuer
813792293OtherWAITINS

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

State licenses

LicenseStateTypeSpecialty
PY60736580WAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1413331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1124422464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 NW 54TH ST STE 215",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981073572",
            "telephone_number": "206-929-9749",
            "fax_number": "206-681-9996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 NW 54TH ST STE 215",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981073572",
            "telephone_number": "206-929-9749",
            "fax_number": "206-681-9996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "STEPHANIE",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-15",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY60736580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ITINS",
            "identifier": "813792293",
            "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 Oct 19, 2022; 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.