Active NPI
Mary Joy F Gumiran
- Adult Development & Aging Psychologist
- Shoreline, WA
National Provider Identifier
1376251439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Development & Aging Psychologist
- License
- 755907
- Practice address
- 15503 8TH Ave NE
Shoreline, WA 98155-6238 - Phone
- (360) 660-4201
- Fax
- (206) 237-9222
- NPI assigned
- Nov 8, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Adult Development & Aging Psychologist | 103TA0700X | 755907 | WA | Primary |
Addresses
Primary practice location
15503 8TH Ave NE
Shoreline, WA 98155-6238
Mailing address
15503 8TH Ave NE
Shoreline, WA 98155-6238
Phone (360) 660-4201
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 |
|---|---|---|---|
| 755907 | WA | MD | Adult Development & Aging Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1667865600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667865600000",
"number": "1376251439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15503 8TH AVE NE",
"city": "SHORELINE",
"state": "WA",
"postal_code": "981556238",
"telephone_number": "360-660-4201",
"fax_number": "206-237-9222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15503 8TH AVE NE",
"city": "SHORELINE",
"state": "WA",
"postal_code": "981556238",
"telephone_number": "360-660-4201",
"fax_number": "206-237-9222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUMIRAN",
"first_name": "MARY JOY",
"middle_name": "F",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-11-08",
"last_updated": "2022-11-08",
"certification_date": "2022-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TA0700X",
"taxonomy_group": "",
"desc": "Psychologist, Adult Development & Aging",
"state": "WA",
"license": "755907",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shoreline, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.