Active NPI
Fangying Stephanie Shi, PHD
- Psychologist
- Sammamish, WA
National Provider Identifier
1497510523
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 61466990
- Practice address
- 25709 SE 32ND PL
Sammamish, WA 98075-9165 - Phone
- (425) 358-8087
- NPI assigned
- Feb 19, 2024
- 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 | 071006062 | IL | |
| Psychologist | 103T00000X | 61466990 | WA | Primary |
Addresses
Primary practice location
25709 SE 32ND PL
Sammamish, WA 98075-9165
Mailing address
704 228TH Ave NE Ste 1068
Sammamish, WA 98074-7222
Phone (425) 358-8087
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61466990 | WA | MD | Psychologist |
| 071006062 | IL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1708300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708300800000",
"number": "1497510523",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "704 228TH AVE NE STE 1068",
"city": "SAMMAMISH",
"state": "WA",
"postal_code": "980747222",
"telephone_number": "425-358-8087"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25709 SE 32ND PL",
"city": "SAMMAMISH",
"state": "WA",
"postal_code": "980759165",
"telephone_number": "425-358-8087"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHI",
"first_name": "FANGYING",
"middle_name": "STEPHANIE",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-02-19",
"last_updated": "2024-02-19",
"certification_date": "2024-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071006062",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WA",
"license": "61466990",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sammamish, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.