NPIMap

Organization Active NPI

Beth Wilson, PHD

  • Psychologist
  • Bellevue, WA
National Provider Identifier
1508389347
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY00002288 Issued in WA
Legal business name
BETH WILSON, PHD
Practice address
1621 114TH Ave SE Ste 221
Bellevue, WA 98004-6905
Phone
(425) 802-5232
Fax
(425) 688-9987
NPI assigned
Jul 24, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Elizabeth Jane Wilson, PHDNPI 1598784399
Title
Sole Proprietor
Phone
(425) 802-5232

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X PY00002288 WA Primary

Addresses

Primary practice location

1621 114TH Ave SE Ste 221
Bellevue, WA 98004-6905

Mailing address

1621 114TH Ave SE Ste 221
Bellevue, WA 98004-6905
Phone (425) 802-5232

National Provider Directory

National Provider Directory

Locations

1621 114th Ave SE
Ste 221
Bellevue, WA 98004
Phone (425) 455-9900

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1500854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1508389347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1621 114TH AVE SE STE 221",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980046905",
            "telephone_number": "425-802-5232",
            "fax_number": "425-688-9987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1621 114TH AVE SE STE 221",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980046905",
            "telephone_number": "425-802-5232",
            "fax_number": "425-688-9987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETH WILSON, PHD",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-24",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "425-802-5232",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY00002288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.