Active NPI
Troy Edward Fenlason, PSY.D.
- Clinical Psychologist
- Leavenworth, WA
National Provider Identifier
1396887477
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY60090118
- Practice address
- 12437 Plain Ranches Rd
Leavenworth, WA 98826-9744 - Phone
- (425) 275-2637
- Fax
- (206) 299-2289
- NPI assigned
- Feb 13, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY60090118 | WA | Primary |
Addresses
Primary practice location
12437 Plain Ranches Rd
Leavenworth, WA 98826-9744
Mailing address
PO Box 2107
Leavenworth, WA 98826-2107
Phone (425) 275-2637
Other practice location 1
316 Main St Ste A2
Edmonds, WA 98020-3197
Phone (425) 275-2637
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 |
|---|---|---|---|
| PY60090118 | WA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Erh Inc | Clinical | Current | Accepting new patients |
Locations
316 Main St
Ste A2
Edmonds, WA 98020
Phone (425) 275-2637
2611 NE 125th St
Ste 111
Seattle, WA 98125
Phone (206) 324-3581
Organizations & group practices 1
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.
-
- Clinical Psychologist
- Leavenworth, WA
- NPI 1649421587
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730851200000",
"number": "1396887477",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2107",
"city": "LEAVENWORTH",
"state": "WA",
"postal_code": "988262107",
"telephone_number": "425-275-2637",
"fax_number": "206-299-2289"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12437 PLAIN RANCHES RD",
"city": "LEAVENWORTH",
"state": "WA",
"postal_code": "988269744",
"telephone_number": "425-275-2637",
"fax_number": "206-299-2289"
}
],
"practiceLocations": [
{
"address_1": "316 Main St Ste A2",
"address_purpose": "LOCATION",
"city": "Edmonds",
"state": "WA",
"postal_code": "980203197",
"country_code": "US",
"telephone_number": "425-275-2637",
"fax_number": "206-299-2289",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FENLASON",
"first_name": "TROY",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-13",
"last_updated": "2024-11-06",
"certification_date": "2024-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PY60090118",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Leavenworth, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.