Sally Deane Bliss, PH.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY 00002266 Issued in WA

Practice address

1740 NW Maple St
Ste. 210
Issaquah, WA 98027-8127

Phone

(425) 625-6874

Fax

(425) 427-2477

NPI assigned

Feb 1, 2007

Last updated

Mar 13, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dr Sally D Bliss PHD PLLC

  • Clinical Psychologist
  • Issaquah, WA
  • NPI 1447783972
  Authorized official Same address or phone

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489363200000",
    "number": "1205973633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 NW MAPLE ST",
            "address_2": "STE. 210",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980278127",
            "telephone_number": "425-625-6874",
            "fax_number": "425-427-2477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 NW MAPLE ST",
            "address_2": "STE. 210",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980278127",
            "telephone_number": "425-625-6874",
            "fax_number": "425-427-2477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLISS",
        "first_name": "SALLY",
        "middle_name": "DEANE",
        "name_prefix": "Ms.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2017-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY 00002266",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "WA",
            "license": "PY 00002266",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY 00002266",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "WA",
            "license": "PY 00002266",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "WA",
            "license": "PY 00002266",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHOLOGIST LICENSE",
            "identifier": "PY 00002266",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Amy Lynne Bliven-Lee, LMHC-A
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• Christopher William Blunt, LMP
• Body Resonance Studio

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2017; 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.