Individual provider Active NPI

Diedra L Clay, PSY.D., CDP

  • Clinical Psychologist
  • Seattle, WA
National Provider Identifier
1205088689
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY00002708 Issued in WA
Practice address
2800 E Madison St Ste 320
Seattle, WA 98112-4871
Phone
(206) 853-8257
NPI assigned
Oct 16, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Psychologist 103TA0400X CP00000182 WA
Clinical Psychologist 103TC0700X PY00002708 WA Primary

Addresses

Primary practice location

2800 E Madison St Ste 320
Seattle, WA 98112-4871

Mailing address

2800 E Madison St Ste 320
Seattle, WA 98112-4871
Phone (206) 853-8257

Other practice location 1

2025 1st Ave
Suite 720
Seattle, WA 98121-2158
Phone (206) 853-8257

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
CP00000182WAMDAddiction (Substance Use Disorder) Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1224115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1205088689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 E MADISON ST STE 320",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981124871",
            "telephone_number": "206-853-8257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 E MADISON ST STE 320",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981124871",
            "telephone_number": "206-853-8257"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2025 1st Ave",
            "address_2": "Suite 720",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981212158",
            "country_code": "US",
            "telephone_number": "206-853-8257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLAY",
        "first_name": "DIEDRA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PSY.D., CDP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-16",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP00000182",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY00002708",
            "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 Mar 17, 2018; 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.