Active NPI
Emily Andresen, PSYD
- Clinical Psychologist
- Seattle, WA
National Provider Identifier
1215624333
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 60194237
- Practice address
- 2901 NE Blakeley St Ste 3B
Seattle, WA 98105-3168 - Phone
- (503) 395-4176
- NPI assigned
- Apr 19, 2023
- Last updated
- Apr 19, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 60194237 | WA | Primary |
Addresses
Primary practice location
2901 NE Blakeley St Ste 3B
Seattle, WA 98105-3168
Mailing address
2901 NE Blakeley St Ste 3B
Seattle, WA 98105-3168
Phone (503) 395-4176
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 2, 2024 through Jan 2, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60194237 | WA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681862400000",
"number": "1215624333",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2901 NE BLAKELEY ST STE 3B",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981053168",
"telephone_number": "503-395-4176"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2901 NE BLAKELEY ST STE 3B",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981053168",
"telephone_number": "503-395-4176"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDRESEN",
"first_name": "EMILY",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-04-19",
"last_updated": "2023-04-19",
"certification_date": "2023-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "60194237",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
- Andrea Kurtz Acupuncturist and Chinese Herbalist, PS, Inc (Sound View Acupuncture)
- Kindra Andreas, RN, BSN
- Chelsia Andreassen
- Rebecca Ann Andrei
- Rhiannon Trozzi Andreini, MA, LMHCA
- Taylor Andresen, LMHC
- Andrew Eisen Physical Therapy, LLC
- Andrew G Franklin DDS PLLC
- Andrew Juechter ND PLLC
- Andrew Meeks Psychiatry PLLC (Balanced Path Psychiatry)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.