Gary Russell Snyder, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1110 Issued in WA

Practice address

15446 Bel Red Road NE
Suite 430
Redmond, WA 98052-5507

Phone

(425) 885-3535

NPI assigned

Nov 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447326301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15446 BEL RED ROAD NE",
            "address_2": "SUITE 430",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980525507",
            "telephone_number": "425-885-3535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15446 BEL RED ROAD NE",
            "address_2": "SUITE 430",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980525507",
            "telephone_number": "425-885-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNYDER",
        "first_name": "GARY",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "1110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGANCE RIDER #",
            "identifier": "SN5020",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara Elizabeth Smith, LMP
• Stuart Todd Smith, DDS
• Jane E Snatic, ARNP
• Sarah Snider, MA
• Caroline Snijder Van Wissenkerke, LMP
• Mee-Sun So, PHARMD
• Atousa Sobhi, MD
• Agnieszka Katarzyna Sobol
• Kourtney Soderholm
• Nabiha F Soherwardi

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.