Individual provider Active NPI

Jane Ellen Curtis, PH.D.

  • Clinical Psychologist
  • Bainbridge Island, WA
National Provider Identifier
1295926210
Registry record updated Aug 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY00002202 Issued in WA
Practice address
11290 Sunrise Dr NE
Bainbridge Island, WA 98110-1353
Phone
(206) 780-7782
Fax
(206) 780-1964
NPI assigned
Aug 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY00002202 WA Primary

Addresses

Primary practice location

11290 Sunrise Dr NE
Bainbridge Island, WA 98110-1353

Mailing address

11290 Sunrise Dr NE
Bainbridge Island, WA 98110-1353
Phone (206) 780-7782

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
I20110912000548 WA Practitioner - Clinical Psychologist 3678744208 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lifespan Psychological Services PSGroup PAC ID 8224326384, 4 clinicians

Practice addresses (Care Compare)

11290 Sunrise Dr NE
Suite B
Bainbridge Island, WA 98110-1353
Phone (206) 780-7782

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PY00002202WAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Assessment Services, PLLC Clinical CurrentSince Jul 7, 2024 Accepting new patients
Lifespan Psychological Services, PS Clinical CurrentSince Aug 29, 2016 Accepting new patients

Locations

11290 Sunrise Dr NE
Ste B
Bainbridge Island, WA 98110
Phone (206) 714-8905

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186358400000",
    "number": "1295926210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11290 SUNRISE DR NE",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981101353",
            "telephone_number": "206-780-7782",
            "fax_number": "206-780-1964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11290 SUNRISE DR NE",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981101353",
            "telephone_number": "206-780-7782",
            "fax_number": "206-780-1964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CURTIS",
        "first_name": "JANE",
        "middle_name": "ELLEN",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-06",
        "last_updated": "2007-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY00002202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bainbridge Island, WA

Sources for this page

Verify at the official NPI Registry.