Active NPI
Gareth Ian Holman, PH.D.
- Clinical Psychologist
- Seattle, WA
National Provider Identifier
1285980599
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY60382108
- Practice address
- 3245 Fairview Ave E
Seattle, WA 98102-3053 - Phone
- (206) 334-2755
- Fax
- (206) 299-3857
- NPI assigned
- Jul 24, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY60382108 | WA | Primary |
Addresses
Primary practice location
3245 Fairview Ave E
Seattle, WA 98102-3053
Mailing address
11729 26TH Ave NE
Seattle, WA 98125-5309
Phone (206) 334-2755
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY60382108 | WA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390435200000",
"number": "1285980599",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11729 26TH AVE NE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981255309",
"telephone_number": "206-334-2755",
"fax_number": "206-299-3857"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3245 FAIRVIEW AVE E",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981023053",
"telephone_number": "206-334-2755",
"fax_number": "206-299-3857"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLMAN",
"first_name": "GARETH",
"middle_name": "IAN",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-07-24",
"last_updated": "2014-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PY60382108",
"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 Jan 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.