Individual provider Active NPI

Jennifer L Bearse, PSYD

  • Clinical Psychologist
  • Vancouver, WA
National Provider Identifier
1487933040
Registry record updated Feb 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY60463236 Issued in WA
Practice address
800 Officers Row Ste D
Vancouver, WA 98661-3847
Phone
(360) 603-9443
Fax
(360) 603-9442
NPI assigned
Aug 12, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Group Psychotherapy Psychologist 103TP2701X PY60463236 WA
Psychologist 103T00000X 2527 OR
Clinical Psychologist 103TC0700X PY60463236 WA Primary

Addresses

Primary practice location

800 Officers Row Ste D
Vancouver, WA 98661-3847

Mailing address

PO Box 61809
Vancouver, WA 98666-1809
Phone (360) 603-9443

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
I20141007002118 WA Practitioner - Clinical Psychologist 7810117215 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

800 Officers Row
Suite D
Vancouver, WA 98661-3847
Phone (360) 603-9443

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2527ORMDPsychologist
PY60463236WAMDGroup Psychotherapy Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Jennifer Bearse PSYD LLC Clinical CurrentSince Sep 1, 2014 Accepting new patients

Locations

800 Officers Row
Ste D
Vancouver, WA 98661
Phone (360) 513-1888

1701 E Evergreen Blvd
Vancouver, WA 98661
Phone (360) 281-3114

Organizations & group practices 1

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": "1313107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738454400000",
    "number": "1487933040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 61809",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986661809",
            "telephone_number": "360-603-9443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 OFFICERS ROW STE D",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986613847",
            "telephone_number": "360-603-9443",
            "fax_number": "360-603-9442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEARSE",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-12",
        "last_updated": "2025-02-02",
        "certification_date": "2025-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "WA",
            "license": "PY60463236",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OR",
            "license": "2527",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY60463236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.