Individual provider Active NPI

Junghee Park-Adams, PH.D.

  • Clinical Psychologist
  • Kirkland, WA
National Provider Identifier
1366619355
Registry record updated Apr 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY60178887 Issued in WA
Practice address
10611 106TH PL NE
Kirkland, WA 98033-4429
Phone
(425) 739-0575
Fax
(425) 968-7522
NPI assigned
May 9, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY16631 CA
Clinical Psychologist 103TC0700X PY60178887 WA Primary

Addresses

Primary practice location

10611 106TH PL NE
Kirkland, WA 98033-4429

Mailing address

10611 106TH PL NE
Kirkland, WA 98033-4429
Phone (425) 739-0575

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 20, 2026 through Jan 20, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY16631CAMDClinical Psychologist
PY60178887WAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1210291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1366619355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10611 106TH PL NE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980334429",
            "telephone_number": "425-739-0575",
            "fax_number": "425-968-7522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10611 106TH PL NE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980334429",
            "telephone_number": "425-739-0575",
            "fax_number": "425-968-7522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK-ADAMS",
        "first_name": "JUNGHEE",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-09",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY16631",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY60178887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

Verify at the official NPI Registry.