Brandon T Matsumiya, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY61346917 Issued in WA

Practice address

21600 Highway 99 Ste 290
Edmonds, WA 98026-8022

Phone

(425) 673-3456

Fax

(425) 673-3474

NPI assigned

May 17, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• Swedish Health Services

  • Family Medicine Physician
  • Seattle, WA
  • NPI 1831139724
  Medicare reassignment NPD
• Swedish Health Services

  • Physical Therapist
  • Seattle, WA
  • NPI 1619680840
  NPD

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

{
    "created_epoch": "1621209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1497329114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4476",
            "fax_number": "206-568-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21600 HIGHWAY 99 STE 290",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980268022",
            "telephone_number": "425-673-3456",
            "fax_number": "425-673-3474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATSUMIYA",
        "first_name": "BRANDON",
        "middle_name": "T",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-17",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY61346917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2261022",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vicki Ann Mason, OT/L
• Michelle Elaine Massey, LICSW
• Theodore Raymond Matheny, MD
• Olivia Danielle Mathisen-Holloman, R.D.N.
• Andrea Matrone
• Monica Matthews, LMHCA, MHP, SUDPT
• Kailey Anne Matulich
• Thomas Matysik
• Joyce E Mauk, MD
• Cesario Aristeo May Garcia, LICSW

• Clinical Psychologist in Edmonds, WA
• Providers in Edmonds, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; 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.