Individual provider Active NPI

Bryan Keith Robison, PSY.D.

  • Psychologist
  • Tacoma, WA
National Provider Identifier
1255367181
Registry record updated Aug 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY00002935 Issued in WA
Practice address
Madigan Army Medical Center
9040 Reid Street, Attn: MCHJ-CLQ-C
Tacoma, WA 98431-1100
Phone
(253) 968-2252
Fax
(253) 968-3278
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY2935 WA
Psychologist 103T00000X PY00002935 WA Primary

Addresses

Primary practice location

Madigan Army Medical Center
9040 Reid Street, Attn: MCHJ-CLQ-C
Tacoma, WA 98431-1100

Mailing address

Madigan Army Medical Center
9040 Reid Street, Attn: MCHJ-CLQ-C
Tacoma, WA 98431-1100
Phone (253) 968-2252

Other identifiers 2

IdentifierTypeStateIssuer
PY2935OtherWASTATE LICENSE #
0181503OtherWALABOR AND INDUSTRIES

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041022000268 WA Practitioner - Clinical Psychologist 3577524610 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY00002935WAMDPsychologist
PY2935WAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services-Washington CurrentSince Oct 1, 2016 Accepting new patients
Providence Health & Services-Wa Current Accepting new patients

Locations

900 Pacific Ave
Everett, WA 98201
Phone (425) 258-7900

1321 Colby Ave
Everett, WA 98201
Phone (425) 259-4413

900 Pacific Ave
Fl 5
Everett, WA 98201
Phone (425) 258-7311

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1255367181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MADIGAN ARMY MEDICAL CENTER",
            "address_2": "9040 REID STREET, ATTN: MCHJ-CLQ-C",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984311100",
            "telephone_number": "253-968-2252",
            "fax_number": "253-968-3278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MADIGAN ARMY MEDICAL CENTER",
            "address_2": "9040 REID STREET, ATTN: MCHJ-CLQ-C",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984311100",
            "telephone_number": "253-968-2252",
            "fax_number": "253-968-3278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBISON",
        "first_name": "BRYAN",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY2935",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY00002935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE #",
            "identifier": "PY2935",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "0181503",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.