Active NPI
Patrick J Raue, PH.D.
- Clinical Psychologist
- Seattle, WA
National Provider Identifier
1245400811
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY60711358
- Practice address
- 4225 Roosevelt Way NE
Seattle, WA 98105-6099 - Phone
- (206) 598-7792
- NPI assigned
- Mar 10, 2008
- Sex
- Male
- 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 | PY60711358 | WA | Primary |
Addresses
Primary practice location
4225 Roosevelt Way NE
Seattle, WA 98105-6099
Mailing address
PO Box 50095
Seattle, WA 98145
Phone (206) 543-7792
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245400811 | Medicaid | WA |
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
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1245400811",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 50095",
"city": "SEATTLE",
"state": "WA",
"postal_code": "98145",
"telephone_number": "206-543-7792"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4225 ROOSEVELT WAY NE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981056099",
"telephone_number": "206-598-7792"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAUE",
"first_name": "PATRICK",
"middle_name": "J",
"name_prefix": "Prof.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-03-10",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PY60711358",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1245400811",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.