Individual provider Active NPI

Alisa Lynn Murray, PH.D., E-R.Y.T.

  • Clinical Psychologist
  • Kent, WA
National Provider Identifier
1265457576
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY00002020 Issued in WA
Practice address
26461 104TH Ave SE
Kent, WA 98030-7668
Phone
(253) 242-8828
NPI assigned
Jul 13, 2006
Last updated
Feb 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY00002020 WA
Clinical Psychologist 103TC0700X PY00002020 WA Primary

Addresses

Primary practice location

26461 104TH Ave SE
Kent, WA 98030-7668

Mailing address

26461 104TH Ave SE
Kent, WA 98030-7668
Phone (253) 242-8828

Other names 1

  • Dr. Alisa Lynn Ostgard-Murray Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Oct 1, 2023 through Oct 1, 2027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PY00002020WAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Alisa Murray PHD LLC Clinical CurrentSince Jul 9, 2023 Accepting new patients
Good Samaritan Hospital Past Accepting new patients
Valley Counseling Associates Past Accepting new patients

Locations

26461 104th Ave SE
Kent, WA 98030
Phone (253) 242-8828

14900 Interurban Ave S
Ste 271
Tukwila, WA 98168
Phone (206) 579-3926

Organizations & group practices 3

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1265457576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26461 104TH AVE SE",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980307668",
            "telephone_number": "253-242-8828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26461 104TH AVE SE",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980307668",
            "telephone_number": "253-242-8828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURRAY",
        "first_name": "ALISA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PH.D., E-R.Y.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY00002020",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY00002020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALISA",
            "last_name": "OSTGARD-MURRAY",
            "middle_name": "LYNN",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kent, WA

Sources for this page

Verify at the official NPI Registry.