Individual provider Active NPI

Chad Joseph Sanders, PH.D.

  • Clinical Psychologist
  • Pullman, WA
National Provider Identifier
1255873857
Registry record updated May 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY60683489 Issued in WA
Practice address
825 SE Bishop Blvd Ste 201
Pullman, WA 99163-5517
Phone
(509) 339-2394
NPI assigned
Nov 14, 2016
Last updated
May 25, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PY60683489 WA
Clinical Psychologist 103TC0700X PY60683489 WA Primary

Addresses

Primary practice location

825 SE Bishop Blvd Ste 201
Pullman, WA 99163-5517

Mailing address

825 SE Bishop Blvd Ste 201
Pullman, WA 99163-5517
Phone (509) 338-6000

Other practice location 1

1125 SE Washington St
Pullman, WA 99164-2302
Phone (509) 335-6285

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
I20170724003554 WA Practitioner - Clinical Psychologist 3779853734 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

405 S Grand Ave
Suite a
Pullman, WA 99163-2712
Phone (661) 496-7367

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY60683489WAMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pullman Behavioral Health PLLC Clinical CurrentSince May 1, 2023 Accepting new patients

Locations

405 S Grand Ave
Ste A
Pullman, WA 99163
Phone (509) 339-6401

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1479081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653436800000",
    "number": "1255873857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 SE BISHOP BLVD STE 201",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635517",
            "telephone_number": "509-338-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 SE BISHOP BLVD STE 201",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635517",
            "telephone_number": "509-339-2394"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1125 SE Washington St",
            "address_purpose": "LOCATION",
            "city": "Pullman",
            "state": "WA",
            "postal_code": "991642302",
            "country_code": "US",
            "telephone_number": "509-335-6285",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "CHAD",
        "middle_name": "JOSEPH",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-14",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "WA",
            "license": "PY60683489",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY60683489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pullman, WA

Sources for this page

Verify at the official NPI Registry.