Individual provider Active NPI

Susannah Emily David, PH.D

  • Clinical Psychologist
  • Tacoma, WA
National Provider Identifier
1487738712
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3562 Issued in WA
Practice address
9601 Steilacoom Blvd SW
Western State Hospital Ward C-5
Tacoma, WA 98498-7213
Phone
(253) 756-2359
NPI assigned
Oct 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 3562 WA Primary

Addresses

Primary practice location

9601 Steilacoom Blvd SW
Western State Hospital Ward C-5
Tacoma, WA 98498-7213

Mailing address

10620 Olympic PL
Anderson Island, WA 98303-8770
Phone (253) 514-1143

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061117000387 WA Practitioner - Clinical Psychologist 8628076072 Reassigns benefits to 1 organization
Practice locations: Lacey, WA; Anderson Island, WA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10620 Olympic PL
Anderson Island, WA 98303-8770
Phone (253) 292-6621

10620 Olympic Place
Anderson Island, WA 98303-8770

1226 Carpenter Rd SE
Suite B3
Lacey, WA 98503-2493
Phone (360) 532-0060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
3562WAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Richard P. Brooks, Jr., Arnp, Inc. CurrentSince Jul 1, 2022 Accepting new patients
Department of Social Dept of SHS Div of Instns Past Accepting new patients

Locations

1812 Sumner Ave
Ste I
Aberdeen, WA 98520
Phone (360) 532-0060

804 Levee St
Hoquiam, WA 98550
Phone (360) 532-0060

1226 Carpenter Rd SE
Ste B3
Lacey, WA 98503
Phone (360) 491-2232

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1487738712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10620 OLYMPIC PL",
            "city": "ANDERSON ISLAND",
            "state": "WA",
            "postal_code": "983038770",
            "telephone_number": "253-514-1143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9601 STEILACOOM BLVD SW",
            "address_2": "WESTERN STATE HOSPITAL WARD C-5",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984987213",
            "telephone_number": "253-756-2359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVID",
        "first_name": "SUSANNAH",
        "middle_name": "EMILY",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "3562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.