Active NPI
Ruth Morgan Wain, LICENSED PSYCHOL
- Clinical Psychologist
- Lacey, WA
National Provider Identifier
1487929709
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY 60474804
- Practice address
- 4524 Intelco Loop SE
Lacey, WA 98503-5941 - Phone
- (650) 641-2682
- NPI assigned
- Mar 20, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 019051 | NY | |
| Clinical Psychologist | 103TC0700X | PY 60474804 | WA | Primary |
Addresses
Primary practice location
4524 Intelco Loop SE
Lacey, WA 98503-5941
Mailing address
PO Box 7434
Tacoma, WA 98417
Phone (650) 641-2682
Other practice location 1
4524 Intelco Loop SE
Lacey, WA 98503-5941
Phone (800) 275-3243
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY 60474804 | WA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Che Senior Psychological Services, PC | Clinical | Past | Accepting new patients |
| Knapp Street Psychiatry, PC | Clinical | Past | Accepting new patients |
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.
-
- Clinical Psychologist
- Brooklyn, NY
- NPI 1023078219
-
- Clinical Psychologist
- Brooklyn, NY
- NPI 1043248776
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1332201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1523404800000",
"number": "1487929709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7434",
"city": "TACOMA",
"state": "WA",
"postal_code": "98417",
"telephone_number": "650-641-2682"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4524 INTELCO LOOP SE",
"city": "LACEY",
"state": "WA",
"postal_code": "985035941",
"telephone_number": "650-641-2682"
}
],
"practiceLocations": [
{
"address_1": "4524 Intelco Loop SE",
"address_purpose": "LOCATION",
"city": "Lacey",
"state": "WA",
"postal_code": "985035941",
"country_code": "US",
"telephone_number": "800-275-3243",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WAIN",
"first_name": "RUTH",
"middle_name": "MORGAN",
"credential": "LICENSED PSYCHOL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-03-20",
"last_updated": "2018-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "019051",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PY 60474804",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lacey, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.