Gary Vandalfsen, PHD, P.S.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY00001869 Issued in WA

Legal business name

GARY VANDALFSEN, PHD, P.S.

Practice address

11808 Northup Way
Suite W-150
Bellevue, WA 98005-1936

Phone

(425) 822-0242

NPI assigned

May 9, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Gary Allen Vandalfsen, PH.D.

Title

President

Phone

(425) 822-0242

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376757575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11808 NORTHUP WAY",
            "address_2": "SUITE W-150",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980051936",
            "telephone_number": "425-822-0242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11808 NORTHUP WAY",
            "address_2": "SUITE W-150",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980051936",
            "telephone_number": "425-822-0242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY VANDALFSEN, PHD, P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VANDALFSEN",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-822-0242",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY00001869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Amanda Gail Garza, MS, CCC-SLP
• Kaitlyn Savannah Garza
• Ramon Miguel Garza
• Lynn Gasowski, RN
• Stephanie Gastaldi

• Clinical Psychologist in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.