NPIMap

Organization Active NPI

Lifespan Psychological Services, PS

  • Clinical Psychologist
  • Bainbridge Island, WA
National Provider Identifier
1366503633
Registry record updated Sep 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
LIFESPAN PSYCHOLOGICAL SERVICES, PS
Practice address
11290 Sunrise Dr NE
Suite B
Bainbridge Island, WA 98110-1353
Phone
(206) 780-7782
Fax
(206) 780-1964
NPI assigned
Dec 12, 2006
Last updated
Sep 26, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2025

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

Authorized official

Name
Steven Eric Curtis, PHDNPI 1770774176
Title
President
Phone
(206) 780-7782

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X NU Primary
Prescribing (Medical) Psychologist 103TP0016X NU

Addresses

Primary practice location

11290 Sunrise Dr NE
Suite B
Bainbridge Island, WA 98110-1353

Mailing address

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

Other practice location 1

1990 E Lohman Ave
Las Cruces, NM 88001-3172
Phone (206) 780-7782

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161005002866 WA Part B Supplier - Clinic/Group Practice 8224326384 Receives reassigned benefits from 4 practitioners
Practice locations: Bainbridge Island, WA

National Provider Directory

National Provider Directory

Locations

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

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758844800000",
    "number": "1366503633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11290 SUNRISE DR NE STE B",
            "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",
            "address_2": "SUITE B",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981101353",
            "telephone_number": "206-780-7782",
            "fax_number": "206-780-1964"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1990 E Lohman Ave",
            "address_purpose": "LOCATION",
            "city": "Las Cruces",
            "state": "NM",
            "postal_code": "880013172",
            "country_code": "US",
            "telephone_number": "206-780-7782",
            "fax_number": "206-780-1964",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LIFESPAN PSYCHOLOGICAL SERVICES, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A",
        "authorized_official_last_name": "CURTIS",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "206-780-7782",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103TP0016X",
            "taxonomy_group": "",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bainbridge Island, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.