Individual provider Active NPI

Julia Elizabeth Mackaronis, PH.D.

  • Clinical Psychologist
  • Spokane, WA
National Provider Identifier
1497123855
Registry record updated Sep 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY60557407 Issued in WA
Practice address
905 W Riverside Ave
Suite 208
Spokane, WA 99201-1016
Phone
(509) 747-0165
Fax
(509) 747-8016
NPI assigned
Sep 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2015

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 PY60557407 WA Primary

Addresses

Primary practice location

905 W Riverside Ave
Suite 208
Spokane, WA 99201-1016

Mailing address

905 W Riverside Ave
Suite 208
Spokane, WA 99201-1016
Phone (509) 747-0165

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
I20230706002331 WA Practitioner - Clinical Psychologist 0749649465 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of Utah School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Quinault Indian NationGroup PAC ID 0446147086, 6 clinicians

Practice addresses (Care Compare)

1505 Kla Ook Wa Dr
Taholah, WA 98587
Phone (360) 276-4405

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Quinault Indian Nation CurrentSince Apr 24, 2023 Accepting new patients
Neuroeducation Inc PC Clinical PastSince Jun 4, 2018 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: julia.mackaronis@rshc.directbygreenway.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1441152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441152000000",
    "number": "1497123855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 W RIVERSIDE AVE",
            "address_2": "SUITE 208",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992011016",
            "telephone_number": "509-747-0165",
            "fax_number": "509-747-8016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 W RIVERSIDE AVE",
            "address_2": "SUITE 208",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992011016",
            "telephone_number": "509-747-0165",
            "fax_number": "509-747-8016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKARONIS",
        "first_name": "JULIA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-02",
        "last_updated": "2015-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY60557407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.