Active NPI
Doni A. Kwak, PH.D.
- Psychologist
- Edmonds, WA
National Provider Identifier
1437236825
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PY00003289
- Practice address
- 555 Dayton St
Suite J-1
Edmonds, WA 98020-3601 - Phone
- (206) 979-3522
- Fax
- (206) 299-2990
- NPI assigned
- Nov 1, 2006
- Last updated
- Aug 7, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PY00003289 | WA | Primary |
Addresses
Primary practice location
555 Dayton St
Suite J-1
Edmonds, WA 98020-3601
Mailing address
P.O. Box 30809
Seattle, WA 98113
Phone (206) 979-3522
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY00003289 | WA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375833600000",
"number": "1437236825",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 30809",
"city": "SEATTLE",
"state": "WA",
"postal_code": "98113",
"telephone_number": "206-979-3522",
"fax_number": "206-299-2990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "555 DAYTON ST",
"address_2": "SUITE J-1",
"city": "EDMONDS",
"state": "WA",
"postal_code": "980203601",
"telephone_number": "206-979-3522",
"fax_number": "206-299-2990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KWAK",
"first_name": "DONI",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-01",
"last_updated": "2013-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WA",
"license": "PY00003289",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edmonds, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.