Active NPI
Annette Marie Tardif, PHD, MA
- Psychologist
- Tacoma, WA
National Provider Identifier
1508334137
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PY60843912
- Practice address
- 401 Broadway Ste 100
Tacoma, WA 98402-3900 - Phone
- (253) 392-6748
- NPI assigned
- Nov 13, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PY60843912 | WA | Primary |
Addresses
Primary practice location
401 Broadway Ste 100
Tacoma, WA 98402-3900
Mailing address
401 Broadway Ste 100
Tacoma, WA 98402-3900
Phone (253) 392-6748
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Apr 1, 2024 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts, Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1542067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666742400000",
"number": "1508334137",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 BROADWAY STE 100",
"city": "TACOMA",
"state": "WA",
"postal_code": "984023900",
"telephone_number": "253-392-6748"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 BROADWAY STE 100",
"city": "TACOMA",
"state": "WA",
"postal_code": "984023900",
"telephone_number": "253-392-6748"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TARDIF",
"first_name": "ANNETTE",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "PHD, MA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-11-13",
"last_updated": "2022-10-26",
"certification_date": "2022-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WA",
"license": "PY60843912",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.