Grande Ronde Psychiatric Services, PC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

MD60053143 Issued in WA

Legal business name

GRANDE RONDE PSYCHIATRIC SERVICES, PC

Practice address

435 W Bell St
Ste. B-1
Sequim, WA 98382-2916

Phone

(360) 477-3298

Fax

(360) 452-9584

NPI assigned

Jan 4, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Terry Allen Trudel, M.D.

Title

President

Phone

(360) 477-3298

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1357257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357257600000",
    "number": "1306183801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1994 S BAGLEY CREEK RD",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983627454",
            "telephone_number": "360-477-3298",
            "fax_number": "360-452-9584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 W BELL ST",
            "address_2": "STE. B-1",
            "city": "SEQUIM",
            "state": "WA",
            "postal_code": "983822916",
            "telephone_number": "360-477-3298",
            "fax_number": "360-452-9584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANDE RONDE PSYCHIATRIC SERVICES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-04",
        "last_updated": "2013-01-04",
        "status": "A",
        "authorized_official_last_name": "TRUDEL",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-477-3298",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "WA",
            "license": "MD60053143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "0265930",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113092",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Becky L Godby, ARNP
• Gillian C Goodwin, CCC-SLP
• Nancy Ellen Goodwin, LAC
• Shawn Patrick Gould, RN
• Katherine Jane Graham, LMHC
• Elizabeth Jane Gratz, RN
• Ruth Naiomi Greene
• Nicholas Joseph Grinnell, PA-C
• Kathi L. Gunn, ARNP F.N.P.BC
• Joe Clements Guthrie Jr., PT

• Mental Health Clinic/Center (Including Community Mental Health Center) in Sequim, WA
• Providers in Sequim, WA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2013; 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.