Matthew Ponsford, M.A.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY60769223 Issued in WA

Practice address

1740 NW Maple St Ste 210
Issaquah, WA 98027-8127

Phone

(206) 719-8230

NPI assigned

Jul 14, 2016

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1468454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1417300468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 NW MAPLE ST STE 210",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980278127",
            "telephone_number": "206-719-8230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 NW MAPLE ST STE 210",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980278127",
            "telephone_number": "206-719-8230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8226 Bracken Pl SE",
            "address_2": "Ste 200",
            "address_purpose": "LOCATION",
            "city": "Snoqualmie",
            "state": "WA",
            "postal_code": "980659235",
            "country_code": "US",
            "telephone_number": "206-719-8230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PONSFORD",
        "first_name": "MATTHEW",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-14",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC60679555",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY60769223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Sarai Polk Tyler
• Jason Lynn Polk, D.C.
• Mitsuko Pollard, PH.D.
• Katherine Pond
• Deanna Poneman, D.C.
• Melissa Pontes
• Elisabeth Porpylev
• Anna Powell
• Power Up Therapy, LLC
• Powers Enrichment Group Inc (SYNERGY HomeCare North Seattle & South Snohomish County)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.