Individual provider Active NPI

Rudy Lorber, PHD

  • Clinical Neuropsychologist
  • Covington, WA
National Provider Identifier
1437562634
Registry record updated Jun 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PY00003809 Issued in WA
Practice address
27023 164TH Ave SE
Covington, WA 98042-8241
Phone
(253) 394-2885
NPI assigned
Jun 4, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PY00003809 WA Primary

Addresses

Primary practice location

27023 164TH Ave SE
Covington, WA 98042-8241

Mailing address

27023 164TH Ave SE
Covington, WA 98042-8241
Phone (253) 394-2885

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

LicenseStateTypeSpecialty
PY00003809WAMDClinical Neuropsychologist

NPI Registry JSON

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

{
    "created_epoch": "1401840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401840000000",
    "number": "1437562634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27023 164TH AVE SE",
            "city": "COVINGTON",
            "state": "WA",
            "postal_code": "980428241",
            "telephone_number": "253-394-2885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27023 164TH AVE SE",
            "city": "COVINGTON",
            "state": "WA",
            "postal_code": "980428241",
            "telephone_number": "253-394-2885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LORBER",
        "first_name": "RUDY",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-04",
        "last_updated": "2014-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "WA",
            "license": "PY00003809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2014; 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.