NPIMap

Organization Active NPI

East Lake Psychological Services, PS

  • Clinical Psychologist
  • Seattle, WA
National Provider Identifier
1144386236
Registry record updated Jan 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY 1728 Issued in WA
Legal business name
EAST LAKE PSYCHOLOGICAL SERVICES, PS
Practice address
4026 NE 55TH St
Suite D
Seattle, WA 98105-2262
Phone
(425) 785-5887
NPI assigned
Dec 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2011

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

Authorized official

Name
Dr. Yie -Wen Yuan Kuan, PH.D.NPI 1609929603
Title
Owner
Phone
(425) 785-5887

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PY 1728 WA Primary

Addresses

Primary practice location

4026 NE 55TH St
Suite D
Seattle, WA 98105-2262

Mailing address

4026 NE 55TH St
Suite D
Seattle, WA 98105-2262
Phone (425) 785-5887

National Provider Directory

National Provider Directory

Locations

4026 NE 55th St
Ste D
Seattle, WA 98105

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1167523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295395200000",
    "number": "1144386236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4026 NE 55TH ST",
            "address_2": "SUITE D",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981052262",
            "telephone_number": "425-785-5887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4026 NE 55TH ST",
            "address_2": "SUITE D",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981052262",
            "telephone_number": "425-785-5887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST LAKE PSYCHOLOGICAL SERVICES, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-31",
        "last_updated": "2011-01-19",
        "status": "A",
        "authorized_official_last_name": "KUAN",
        "authorized_official_first_name": "YIE -WEN",
        "authorized_official_middle_name": "YUAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-785-5887",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY 1728",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 19, 2011; 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.