Active NPI
Leihua Edstrom, PHD, ABSNP
- Clinical Child & Adolescent Psychologist
- Mill Creek, WA
National Provider Identifier
1225817877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- PY00002829
- Practice address
- 15129 Main St Ste 201
Mill Creek, WA 98012-9036 - Phone
- (206) 372-6038
- NPI assigned
- Sep 25, 2023
- Sex
- Female
- Sole proprietor
- No
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 Child & Adolescent Psychologist | 103TC2200X | PY00002829 | WA | Primary |
Addresses
Primary practice location
15129 Main St Ste 201
Mill Creek, WA 98012-9036
Mailing address
8601 156TH St SE
Snohomish, WA 98296-8712
Phone (206) 372-6038
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY00002829 | WA | MD | Clinical Child & Adolescent Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695600000000",
"number": "1225817877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8601 156TH ST SE",
"city": "SNOHOMISH",
"state": "WA",
"postal_code": "982968712",
"telephone_number": "206-372-6038"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15129 MAIN ST STE 201",
"city": "MILL CREEK",
"state": "WA",
"postal_code": "980129036",
"telephone_number": "206-372-6038"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDSTROM",
"first_name": "LEIHUA",
"name_prefix": "Dr.",
"credential": "PHD, ABSNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-25",
"last_updated": "2023-09-25",
"certification_date": "2023-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "WA",
"license": "PY00002829",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mill Creek, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.