Organization Active NPI

Paul Reppas PHD PLLC

  • Psychologist
  • Wenatchee, WA
National Provider Identifier
1467986430
Registry record updated Apr 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY60711473 Issued in WA
Legal business name
PAUL REPPAS PHD PLLC
Practice address
23 S Wenatchee Ave
Ste 202
Wenatchee, WA 98801-2264
Phone
(509) 885-9045
Fax
(509) 885-9045
NPI assigned
Apr 17, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2017

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

Authorized official

Name
Paul Reppas, PHD
Title
Owner
Phone
(509) 885-9045

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X PY60711473 WA Primary

Addresses

Primary practice location

23 S Wenatchee Ave
Ste 202
Wenatchee, WA 98801-2264

Mailing address

23 S Wenatchee Ave
Ste 202
Wenatchee, WA 98801-2264
Phone (509) 885-9045

Other identifiers 1

IdentifierTypeStateIssuer
2077655MedicaidWA

National Provider Directory

National Provider Directory

Locations

119 W 5th Ave
Ste 201
Ellensburg, WA 98926
Phone (509) 885-9045

NPI Registry JSON

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

{
    "created_epoch": "1492387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492992000000",
    "number": "1467986430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 S WENATCHEE AVE",
            "address_2": "STE 202",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012264",
            "telephone_number": "509-885-9045",
            "fax_number": "509-885-9045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 S WENATCHEE AVE",
            "address_2": "STE 202",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012264",
            "telephone_number": "509-885-9045",
            "fax_number": "509-885-9045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL REPPAS PHD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-17",
        "last_updated": "2017-04-24",
        "status": "A",
        "authorized_official_last_name": "REPPAS",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-885-9045",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY60711473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2077655",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wenatchee, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.