Individual provider Active NPI

Jeffrey Arthur Grant, PHD

  • Psychologist
  • Seattle, WA
National Provider Identifier
1396124012
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY60736567 Issued in WA
Practice address
4500 9TH Ave NE Ste 300
Seattle, WA 98105-4762
Phone
(206) 414-9322
NPI assigned
May 27, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY60736567 WA Primary
Mental Health Counselor 101YM0800X LH60486891 WA

Addresses

Primary practice location

4500 9TH Ave NE Ste 300
Seattle, WA 98105-4762

Mailing address

4500 9TH Ave NE Ste 300
Seattle, WA 98105-4762
Phone (206) 414-9322

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Aug 22, 2023 through Aug 22, 2027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LH60486891WAMDMental Health Counselor
PY60736567WAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Portage Bay Clinic Current Accepting new patients
Wellspring Family Services Past Accepting new patients

Locations

4500 9th Ave NE
Ste 300
Seattle, WA 98105
Phone (206) 234-6932

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1432684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1396124012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 9TH AVE NE STE 300",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981054762",
            "telephone_number": "206-414-9322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 9TH AVE NE STE 300",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981054762",
            "telephone_number": "206-414-9322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "JEFFREY",
        "middle_name": "ARTHUR",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-27",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY60736567",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60486891",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.