NPIMap

Organization Active NPI

Mary Candelaria

  • Psychologist
  • Everett, WA
National Provider Identifier
1154534105
Registry record updated Sep 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2200 Issued in WA
Legal business name
MARY CANDELARIA
Practice address
127 E Intercity Ave Ste a
Everett, WA 98208-2732
Phone
(425) 347-7275
Fax
(425) 355-0626
NPI assigned
May 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2008

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

Authorized official

Name
Dr. Mary F Candelaria, PSYDNPI 1841330859
Title
Owner
Phone
(425) 347-7275

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 2200 WA Primary

Addresses

Primary practice location

127 E Intercity Ave Ste a
Everett, WA 98208-2732

Mailing address

127 E Intercity Ave Ste a
Everett, WA 98208-2732
Phone (425) 347-7275

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221696000000",
    "number": "1154534105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 E INTERCITY AVE STE A",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982082732",
            "telephone_number": "425-347-7275",
            "fax_number": "425-355-0626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 E INTERCITY AVE STE A",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982082732",
            "telephone_number": "425-347-7275",
            "fax_number": "425-355-0626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY CANDELARIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2008-09-18",
        "status": "A",
        "authorized_official_last_name": "CANDELARIA",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-347-7275",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "WA",
            "license": "2200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2008; 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.