Active NPI
Crystal Lee Marchese, PSYD
- Clinical Psychologist
- Tacoma, WA
National Provider Identifier
1518139641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 0810008062
- Practice address
- 9040 Jackson Ave
Tacoma, WA 98431-0001 - Phone
- (253) 968-2820
- NPI assigned
- Mar 28, 2008
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | #C3548 | OR | |
| Clinical Psychologist | 103TC0700X | 0810008062 | VA | Primary |
Addresses
Primary practice location
9040 Jackson Ave
Tacoma, WA 98431-0001
Mailing address
9040 Jackson Ave
Tacoma, WA 98431-0001
Phone (253) 968-2820
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| #C3548 | OR | MD | Mental Health Counselor |
| 0810008062 | VA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673827200000",
"number": "1518139641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9040 JACKSON AVE",
"city": "TACOMA",
"state": "WA",
"postal_code": "984310001",
"telephone_number": "253-968-2820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9040 JACKSON AVE",
"city": "TACOMA",
"state": "WA",
"postal_code": "984310001",
"telephone_number": "253-968-2820"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARCHESE",
"first_name": "CRYSTAL",
"middle_name": "LEE",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-28",
"last_updated": "2023-01-16",
"certification_date": "2023-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "#C3548",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VA",
"license": "0810008062",
"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 Jan 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.