Active NPI
Nora L Bloomingdale, PSYD
- Clinical Psychologist
- Everett, WA
National Provider Identifier
1407241409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY60674062
- Practice address
- 4216 122ND PL SE
Everett, WA 98208-9100 - Phone
- (425) 475-1207
- NPI assigned
- Apr 6, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LH60562634 | WA | |
| Clinical Psychologist | 103TC0700X | PY60674062 | WA | Primary |
Addresses
Primary practice location
4216 122ND PL SE
Everett, WA 98208-9100
Mailing address
16706 30TH Dr SE
Bothell, WA 98012-6039
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 1, 2025 through Oct 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LH60562634 | WA | MD | Mental Health Counselor |
| PY60674062 | WA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676937600000",
"number": "1407241409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16706 30TH DR SE",
"city": "BOTHELL",
"state": "WA",
"postal_code": "980126039",
"fax_number": "847-217-4191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4216 122ND PL SE",
"city": "EVERETT",
"state": "WA",
"postal_code": "982089100",
"telephone_number": "425-475-1207"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLOOMINGDALE",
"first_name": "NORA",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-04-06",
"last_updated": "2023-02-21",
"certification_date": "2023-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "LH60562634",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PY60674062",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Everett, WA
- Fredrick Thomas Bletson Jr.
- Ludmila Blindauer
- Martina P. Block, ARNP, DNP
- Myra Marie Block
- Amber Marie Blomquist
- Marci Lynn Bloomquist, RC
- Blossom Mental Health Services, PLLC
- Riddhi Blow, N.D.
- Blue Wave Eye Doctors Professional Limited Liability Company
- Blue Wave Eye Doctors Professional Limited Liability Company
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.