Jordan Gerald Houghton, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY61291458 Issued in WA

Practice address

12025 115TH Ave NE Ste 200
Kirkland, WA 98034-6935

Phone

(425) 821-1810

NPI assigned

Oct 24, 2019

Reactivated

Dec 14, 2022

Last updated

Feb 9, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pacific Islamic Community and Cultural Services

  dba PICACS Clinic

  • Community/Behavioral Health Agency
  • Bothell, WA
  • NPI 1467905695
  NPD (past)

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

{
    "created_epoch": "1571875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1376186031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10516 CORNELL AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981782631",
            "telephone_number": "206-898-7912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12025 115TH AVE NE STE 200",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980346935",
            "telephone_number": "425-821-1810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUGHTON",
        "first_name": "JORDAN",
        "middle_name": "GERALD",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-24",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "deactivation_date": "2022-09-06",
        "reactivation_date": "2022-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY61291458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jordan@consciouswarriorcollaborative.com",
            "affiliation": "N",
            "endpointDescription": "Secure HIPPA email for CWC, PLLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "10516 Cornell Ave S",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981782631",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Linda Nguyen Hou, O.D.
• Amber Houchin
• Krista Nicole Hough, CPHT
• Rachel Diane Hough, RN
• Houghton Physical Therapy LLC (Lake Washington Physical Therapy)
• Rebecca Houghton
• Christina Houk, PT
• Kecia Howard
• Joan Marie Howe, DPT
• Theodore Howell

• Psychologist in Kirkland, WA
• Providers in Kirkland, WA by specialty
• Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; 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.