Individual provider Active NPI

Virginia Grafton Becker, PSYD

  • Clinical Psychologist
  • Shoreline, WA
National Provider Identifier
1225187297
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY00001311 Issued in WA
Practice address
727 N 182ND St
Suite 202
Shoreline, WA 98133-4402
Phone
(206) 542-6670
Fax
(206) 542-5235
NPI assigned
Jan 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY00001311 WA Primary

Addresses

Primary practice location

727 N 182ND St
Suite 202
Shoreline, WA 98133-4402

Mailing address

727 N 182ND St
Suite 202
Shoreline, WA 98133-4402
Phone (206) 542-6670

Other identifiers 2

IdentifierTypeStateIssuer
GR2317OtherWAREGENCE PIN
5374575OtherAETNA US HEALTHCARE

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
PY00001311WAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1225187297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "727 N 182ND ST",
            "address_2": "SUITE 202",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981334402",
            "telephone_number": "206-542-6670",
            "fax_number": "206-542-5235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 N 182ND ST",
            "address_2": "SUITE 202",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981334402",
            "telephone_number": "206-542-6670",
            "fax_number": "206-542-5235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKER",
        "first_name": "VIRGINIA",
        "middle_name": "GRAFTON",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY00001311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE PIN",
            "identifier": "GR2317",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTHCARE",
            "identifier": "5374575",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreline, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.