Individual provider Active NPI

Douglas C. Haldeman, PH.D.

  • Psychologist
  • Seattle, WA
National Provider Identifier
1275668436
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY1072 Issued in WA
Practice address
2001 Western Ave
Suite 310
Seattle, WA 98121-2163
Phone
(206) 443-4306
Fax
(206) 728-1180
NPI assigned
Feb 21, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY1072 WA Primary

Addresses

Primary practice location

2001 Western Ave
Suite 310
Seattle, WA 98121-2163

Mailing address

2001 Western Ave
Suite 310
Seattle, WA 98121-2163
Phone (206) 443-4306

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PY1072WAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Judith L. Warren, PH.D., P.S. Past Accepting new patients

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": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275668436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 WESTERN AVE",
            "address_2": "SUITE 310",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981212163",
            "telephone_number": "206-443-4306",
            "fax_number": "206-728-1180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 WESTERN AVE",
            "address_2": "SUITE 310",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981212163",
            "telephone_number": "206-443-4306",
            "fax_number": "206-728-1180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALDEMAN",
        "first_name": "DOUGLAS",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY1072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.