Jeffrey Bruce Gillman, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY00002232 Issued in WA

Practice address

18500 156TH Ave NE
Suite #202
Woodinville, WA 98072-4459

Phone

(425) 591-8889

Fax

(425) 481-2157

NPI assigned

Jan 22, 2007

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": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184778813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18500 156TH AVE NE",
            "address_2": "SUITE #202",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "980724459",
            "telephone_number": "425-591-8889",
            "fax_number": "425-481-2157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18500 156TH AVE NE",
            "address_2": "SUITE #202",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "980724459",
            "telephone_number": "425-591-8889",
            "fax_number": "425-481-2157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLMAN",
        "first_name": "JEFFREY",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY00002232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kari Galvagno
• Lizabet Gangnes
• Shifali Garg, DDS
• Jared Gee, DPT
• Susan Ghaffari
• Demetri Ginosatis, DMD, MSD
• Elizabeth Glomb
• Cameo A R Godsey, LMT
• Yogesh Goel, DMD
• Amanda Golant, REGISTERED DIETITIAN

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.