NPIMap

Organization Active NPI

Jennifer Gross, PSYD, Inc

  • Clinic/Center
  • Mill Creek, WA
National Provider Identifier
1386398816
Registry record updated Feb 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
JENNIFER GROSS, PSYD, INC
Practice address
805 164TH St SE Ste 101
Mill Creek, WA 98012-6316
Phone
(206) 300-6644
Fax
(425) 357-0924
NPI assigned
Feb 3, 2022
Last updated
Feb 3, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2022

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

Authorized official

Name
Jennifer Gross, PSYDNPI 1023197951
Title
Practice Manager
Phone
(206) 300-6644

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

805 164TH St SE Ste 101
Mill Creek, WA 98012-6316

Mailing address

805 164TH St SE Ste 101
Mill Creek, WA 98012-6316
Phone (206) 300-6644

National Provider Directory

National Provider Directory

Locations

805 164th St SE
Ste 101
Mill Creek, WA 98012
Phone (425) 210-4177

Practitioners & affiliated clinicians

Practitioners 6

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": "1643846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643846400000",
    "number": "1386398816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 164TH ST SE STE 101",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980126316",
            "telephone_number": "206-300-6644",
            "fax_number": "425-357-0924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 164TH ST SE STE 101",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980126316",
            "telephone_number": "206-300-6644",
            "fax_number": "425-357-0924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER GROSS, PSYD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-03",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A",
        "authorized_official_last_name": "GROSS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "206-300-6644",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Creek, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.

Verify at the official NPI Registry.