NPIMap

Organization Active NPI

Dr Sally D Bliss PHD PLLC

  • Clinical Psychologist
  • Issaquah, WA
National Provider Identifier
1447783972
Registry record updated Apr 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY 00002266 Issued in WA
Legal business name
DR SALLY D BLISS PHD PLLC
Practice address
1740 NW Maple St
Ste. 210
Issaquah, WA 98027-8127
Phone
(425) 625-6874
Fax
(425) 427-2477
NPI assigned
Apr 11, 2017
Last updated
Apr 11, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2017

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

Authorized official

Name
Dr. Sally Deane Bliss, PHD, MA, BSNNPI 1205973633
Title
Owner/Clinical Psychologist
Phone
(425) 625-6874

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Psychologist 103TA0400X PY 00002266 WA
Cognitive & Behavioral Psychologist 103TB0200X PY 00002266 WA
Clinical Psychologist 103TC0700X PY 00002266 WA Primary
Clinical Child & Adolescent Psychologist 103TC2200X PY 00002266 WA
Family Psychologist 103TF0000X PY 00002266 WA
Psychoanalysis Psychologist 103TP0814X PY 00002266 WA
Rehabilitation Psychologist 103TR0400X PY 00002266 WA

Addresses

Primary practice location

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

Mailing address

1740 NW Maple St
Ste. 210
Issaquah, WA 98027-8127
Phone (425) 625-6874

National Provider Directory

National Provider Directory

Locations

1740 NW Maple St
Ste 210
Issaquah, WA 98027
Phone (425) 584-3632

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1491868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491868800000",
    "number": "1447783972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 NW MAPLE ST",
            "address_2": "STE. 210",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980278127",
            "telephone_number": "425-625-6874",
            "fax_number": "425-427-2477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 NW MAPLE ST",
            "address_2": "STE. 210",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980278127",
            "telephone_number": "425-625-6874",
            "fax_number": "425-427-2477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR SALLY D BLISS PHD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-11",
        "last_updated": "2017-04-11",
        "status": "A",
        "authorized_official_last_name": "BLISS",
        "authorized_official_first_name": "SALLY",
        "authorized_official_middle_name": "DEANE",
        "authorized_official_title_or_position": "OWNER/CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "425-625-6874",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, MA, BSN"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "PY 00002266",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "WA",
            "license": "PY 00002266",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY 00002266",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "WA",
            "license": "PY 00002266",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "WA",
            "license": "PY 00002266",
            "primary": false
        },
        {
            "code": "103TP0814X",
            "taxonomy_group": "",
            "desc": "Psychologist, Psychoanalysis",
            "state": "WA",
            "license": "PY 00002266",
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "WA",
            "license": "PY 00002266",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2017; 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.