NPIMap

Organization Active NPI

Brain and Memory Health Group PLLC

  • Geriatric Psychiatry Physician
  • Seattle, WA
National Provider Identifier
1508612847
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X
Legal business name
BRAIN AND MEMORY HEALTH GROUP PLLC
Practice address
4501 15TH Ave S Ste 102
Seattle, WA 98108-1874
Phone
(425) 494-3554
Fax
(206) 538-2563
NPI assigned
Apr 26, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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

Authorized official

Name
Alice Allen-RedfernNPI 1417666108
Title
Co-Founder
Phone
(425) 494-3554

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
Geriatric Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0805X Primary

Addresses

Primary practice location

4501 15TH Ave S Ste 102
Seattle, WA 98108-1874

Mailing address

4742 42ND Ave SW # 406
Seattle, WA 98116-4553
Phone (425) 494-3554

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240531003564 WA Part B Supplier - Clinic/Group Practice 7012359300 Receives reassigned benefits from 9 practitioners
Practice locations: Seattle, WA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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": "1714089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714348800000",
    "number": "1508612847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4742 42ND AVE SW # 406",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981164553",
            "telephone_number": "425-494-3554",
            "fax_number": "206-538-2563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 15TH AVE S STE 102",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981081874",
            "telephone_number": "425-494-3554",
            "fax_number": "206-538-2563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAIN AND MEMORY HEALTH GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-26",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A",
        "authorized_official_last_name": "ALLEN-REDFERN",
        "authorized_official_first_name": "ALICE",
        "authorized_official_title_or_position": "CO-FOUNDER",
        "authorized_official_telephone_number": "425-494-3554"
    },
    "taxonomies": [
        {
            "code": "2084P0805X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.