Diana Marie Repke, PSYD

Primary specialty

Forensic PsychologistTaxonomy code 103TF0200X

License

PY3594 Issued in WA

Practice address

Building 9930a West Johnson St
Tacoma, WA 98431-1100

Phone

(253) 968-5906

NPI assigned

Feb 14, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Psychological Management Group, PA

  • Counseling Psychologist
  • Tampa, FL
  • NPI 1144384264
  NPD (past)

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

{
    "created_epoch": "1234569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1265671283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9940 JACKSON AVENUE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984311100",
            "telephone_number": "253-968-5906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BUILDING 9930A WEST JOHNSON ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984311100",
            "telephone_number": "253-968-5906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REPKE",
        "first_name": "DIANA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-14",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY3594",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "WA",
            "license": "PY3594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trenton James Reno
• Jose Antonio Renteria, PTA
• Ray Lavarias Reola, OT
• Tiffany Frances-Rose Repar
• Christian Repke, LMP
• John Randall Replogle, MD
• Reproductive Genetics and Fertility
• Luke Matthew Requa, PA-C
• Jercell Respicio
• Restore Integrative Health PLLC

• Forensic Psychologist in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Forensic Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.