Active NPI
Eden Marie Beesley, PSY.D
- Clinical Psychologist
- Tacoma, WA
National Provider Identifier
1336715218
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY60515961
- Practice address
- 2215 N 30TH St
Tacoma, WA 98403-3350 - Phone
- (888) 852-1988
- NPI assigned
- Jun 1, 2021
- Sex
- Female
- 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 | PY60515961 | WA | Primary |
Addresses
Primary practice location
2215 N 30TH St
Tacoma, WA 98403-3350
Mailing address
27547 254TH Way SE
Maple Valley, WA 98038-2045
Phone (775) 771-0522
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY60515961 | WA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622505600000",
"number": "1336715218",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27547 254TH WAY SE",
"city": "MAPLE VALLEY",
"state": "WA",
"postal_code": "980382045",
"telephone_number": "775-771-0522"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2215 N 30TH ST",
"city": "TACOMA",
"state": "WA",
"postal_code": "984033350",
"telephone_number": "888-852-1988"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEESLEY",
"first_name": "EDEN",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "PSY.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-06-01",
"last_updated": "2021-06-01",
"certification_date": "2021-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PY60515961",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.