Active NPI
Miguel A Iracheta, PHD
- Clinical Psychologist
- Bremerton, WA
National Provider Identifier
1144564931
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071.009922
- Practice address
- 120 S Dewey Street
CVN 76
Bremerton, WA 98314-0001 - Phone
- (808) 653-2178
- NPI assigned
- Nov 16, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Psychologist | 103TC0700X | 071.009922 | IL | Primary |
Addresses
Primary practice location
120 S Dewey Street
CVN 76
Bremerton, WA 98314-0001
Mailing address
Unit 100197 Box 2721
Fpo, AP 96616-9727
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071.009922 | IL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1353024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785888000000",
"number": "1144564931",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "MIL",
"address_1": "UNIT 100197 BOX 2721",
"city": "FPO",
"state": "AP",
"postal_code": "966169727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 S DEWEY STREET",
"address_2": "CVN 76",
"city": "BREMERTON",
"state": "WA",
"postal_code": "983140001",
"telephone_number": "808-653-2178"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IRACHETA",
"first_name": "MIGUEL",
"middle_name": "A",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-11-16",
"last_updated": "2026-08-05",
"certification_date": "2026-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071.009922",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bremerton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.