Paul D Connor, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY00002050 Issued in WA

Practice address

22517 7TH Ave S
Des Moines, WA 98198-6820

Phone

(206) 940-1106

Fax

(206) 870-9081

NPI assigned

Oct 16, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WA

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243468800000",
    "number": "1477633378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22517 7TH AVE S",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981986820",
            "telephone_number": "206-940-1106",
            "fax_number": "206-870-9081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22517 7TH AVE S",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981986820",
            "telephone_number": "206-940-1106",
            "fax_number": "206-870-9081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOR",
        "first_name": "PAUL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2009-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY00002050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERNAL ID-MOTOR VEHICLE ID",
            "identifier": "4323",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7144058",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Claiborne, PHARM.D
• Adele Jane Clark, D.C.
• Craig C Coleman, MASSAGE THERAPIST
• Community Works PLLC
• Comprehensive Sleep Medicine Inc PS
• Louis Henry Cook, DC
• Michelle L Cooper, RN
• Courtney Corbit
• Julian Coronas
• Joy L Cosby

• Clinical Psychologist in Des Moines, WA
• Providers in Des Moines, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2009; 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.