Individual provider Active NPI

Jordyn Richardson

  • Clinical Child & Adolescent Psychologist
  • Seattle, WA
National Provider Identifier
1548627490
Registry record updated Jan 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
Practice address
4746 11TH Ave NE
Seattle, WA 98105-4657
Phone
(360) 480-5652
NPI assigned
Jan 23, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X Primary

Addresses

Primary practice location

4746 11TH Ave NE
Seattle, WA 98105-4657

Mailing address

7133 72ND Street CT SW
Lakewood, WA 98498-6300
Phone (360) 480-5652

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

NPI Registry JSON

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

{
    "created_epoch": "1453507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453507200000",
    "number": "1548627490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7133 72ND STREET CT SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984986300",
            "telephone_number": "360-480-5652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4746 11TH AVE NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981054657",
            "telephone_number": "360-480-5652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "JORDYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-23",
        "last_updated": "2016-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "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 Jan 23, 2016; 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.