Individual provider Active NPI

Joy Sumie Kawamura, PHD

  • Clinical Child & Adolescent Psychologist
  • Seattle, WA
National Provider Identifier
1437504123
Registry record updated Dec 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
PY60792875 Issued in WA
Practice address
4800 Sand Point Way NE
Seattle, WA 98105-3901
Phone
(206) 987-2164
NPI assigned
Apr 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X PY60792875 WA Primary

Addresses

Primary practice location

4800 Sand Point Way NE
Seattle, WA 98105-3901

Mailing address

PO Box 5371
Seattle, WA 98145-5005
Phone (206) 987-2164

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, HI2 enrollments
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.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20171214002706 WA Practitioner - Clinical Psychologist 2163780404 Reassigns benefits to 1 organization
I20240912001187 HI Practitioner - Clinical Psychologist 2163780404 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY60792875WAMDClinical Child & Adolescent Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kapiolani Medical Specialists CurrentSince Aug 5, 2024 Accepting new patients
Straub Clinic & Hospital CurrentSince Aug 5, 2024 Accepting new patients
Straub Clinic & Hospital CurrentSince Aug 5, 2024 Accepting new patients

Locations

888 S King St
Honolulu, HI 96813
Phone (808) 522-4000

55 Merchant St
Fl 22
Honolulu, HI 96813
Phone (808) 535-7600

1319 Punahou St
Honolulu, HI 96826
Phone (808) 485-4300

Organizations & group practices 5

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": "1461888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512950400000",
    "number": "1437504123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5371",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981455005",
            "telephone_number": "206-987-2164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 SAND POINT WAY NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981053901",
            "telephone_number": "206-987-2164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAWAMURA",
        "first_name": "JOY",
        "middle_name": "SUMIE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-29",
        "last_updated": "2017-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "WA",
            "license": "PY60792875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.