Active NPI
Kristen R Myers, PSYD, DRPH
- Clinical Psychologist
- Puyallup, WA
National Provider Identifier
1235424375
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY 60200339
- Practice address
- 310 N Meridian
Ste 205
Puyallup, WA 98371-8644 - Phone
- (909) 567-9637
- NPI assigned
- Jun 16, 2011
- 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 Psychologist | 103TC0700X | PY 60200339 | WA | Primary |
Addresses
Primary practice location
310 N Meridian
Ste 205
Puyallup, WA 98371-8644
Mailing address
2708 176TH Ave E
Lake Tapps, WA 98391-9417
Phone (909) 567-9637
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
| License | State | Type | Specialty |
|---|---|---|---|
| PY 60200339 | WA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Emily Program, PC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Psychiatric Residential Treatment Facility
- Seattle, WA
- NPI 1871948257
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308182400000",
"number": "1235424375",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2708 176TH AVE E",
"city": "LAKE TAPPS",
"state": "WA",
"postal_code": "983919417",
"telephone_number": "909-567-9637",
"fax_number": "253-862-9951"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "310 N MERIDIAN",
"address_2": "STE 205",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983718644",
"telephone_number": "909-567-9637"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MYERS",
"first_name": "KRISTEN",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "PSYD, DRPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-16",
"last_updated": "2011-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PY 60200339",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Puyallup, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.