Jack Myron Litman, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

958 Issued in WA

Practice address

7600 NE 41St St
Suite 310
Vancouver, WA 98662-6791

Phone

(360) 253-6425

Fax

(360) 253-3196

NPI assigned

Jan 17, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

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.

• Whipple Creek Wellness Incorporated

  • Psychiatric/Mental Health Nurse Practitioner
  • Vancouver, WA
  • NPI 1508661570
  NPD (past)

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327536000000",
    "number": "1255483715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 NE 41ST ST",
            "address_2": "SUITE 310",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626791",
            "telephone_number": "360-253-6425",
            "fax_number": "360-253-3196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 NE 41ST ST",
            "address_2": "SUITE 310",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626791",
            "telephone_number": "360-253-6425",
            "fax_number": "360-253-3196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITMAN",
        "first_name": "JACK",
        "middle_name": "MYRON",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2012-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Ae Newkirk DDS PLLC
• Michaelann Liss, DO
• Leah Lister, AAC
• Stephen Alan Liston, D.C.,P.S.
• Angela J Litle, LMP
• Kasia Little, DPT
• Mary Bridget Little, LMT , LMP
• Stephanie Ann Little, RN
• Jason Litts
• Angela Liu, MD

• Clinical Psychologist in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.