Shanachie Psychological Services

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

SHANACHIE PSYCHOLOGICAL SERVICES

Practice address

748 Market St # 314
Tacoma, WA 98402-3737

Phone

(626) 842-0383

NPI assigned

Feb 5, 2024

Last updated

Feb 5, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Douglas Warren Lane, PHDNPI 1780732073

Title

Psychologist

Phone

(626) 842-0383

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

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.

• Douglas W Lane, PH. D

  • Clinical Psychologist
  • University Place, WA
  • NPI 1780732073
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1707091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707091200000",
    "number": "1205699055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7182",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984170182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "748 MARKET ST # 314",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984023737",
            "telephone_number": "626-842-0383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANACHIE PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-05",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A",
        "authorized_official_last_name": "LANE",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "WARREN",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "626-842-0383",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Azima Shaji, MD
• Amirali Shakouripartovi, MD
• Shalom Adult Family Home 1 LLC
• Shalom Springs Adult Family Home Inc.
• Zain Shamoon, LMFT
• Guiselda B Shank, BSN RN
• Mamta Shankar, BPHARM
• Gloria Shanks, B.A.
• Briana Christine Shannon
• Dean A Shannon, LMP

• Community/Behavioral Health Agency in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Community/Behavioral Health Agency in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.