Individual provider Active NPI

Caroline Lea Rinke, PHD

  • Clinical Psychologist
  • Mill Creek, WA
National Provider Identifier
1346318847
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY00000472 Issued in WA
Practice address
15418 Main Street
Suite 301
Mill Creek, WA 98012-9030
Phone
(425) 385-3262
Fax
(425) 357-0924
NPI assigned
Dec 1, 2006
Sex
Female
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
Clinical Psychologist 103TC0700X PY00000472 WA Primary

Addresses

Primary practice location

15418 Main Street
Suite 301
Mill Creek, WA 98012-9030

Mailing address

15418 Main Street
Suite 301
Mill Creek, WA 98012-9030
Phone (425) 385-3262

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
I20040515000179 WA Practitioner - Clinical Psychologist 1153311758 Practice locations: Mill Creek, WA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Washington University School of Medicine, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3722 204TH St SW
Lynnwood, WA 98036-6895

805 164TH St SE
Suite 101
Mill Creek, WA 98012-6316
Phone (425) 385-3262

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
472WAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Caroline L Rinke Clinical PastSince Jan 1, 1990 Accepting new patients
Jennifer Gross, PSYD, Inc PastSince Feb 6, 2022 Accepting new patients

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": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346318847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15418 MAIN STREET",
            "address_2": "SUITE 301",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980129030",
            "telephone_number": "425-385-3262",
            "fax_number": "425-357-0924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15418 MAIN STREET",
            "address_2": "SUITE 301",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980129030",
            "telephone_number": "425-385-3262",
            "fax_number": "425-357-0924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RINKE",
        "first_name": "CAROLINE",
        "middle_name": "LEA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY00000472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Creek, WA

Sources for this page

Verify at the official NPI Registry.