Christian Michael Quayle, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

WA 1303 Issued in WA

Practice address

15418 Main St
Suite 301
Mill Creek, WA 98012-9030

Phone

(425) 385-3262

Fax

(425) 357-0924

NPI assigned

Nov 29, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jennifer Gross, PSYD, Inc

  • Clinic/Center
  • Mill Creek, WA
  • NPI 1386398816
  NPD (past)

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558438952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15418 MAIN ST",
            "address_2": "SUITE 301",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980129030",
            "telephone_number": "425-385-3262",
            "fax_number": "425-357-0924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15418 MAIN ST",
            "address_2": "SUITE 301",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980129030",
            "telephone_number": "425-385-3262",
            "fax_number": "425-357-0924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUAYLE",
        "first_name": "CHRISTIAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "WA 1303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7079452",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Purity Integrative Health & Wellness Center, PLLC
• Purity Integrative Health & Wellness Center, PLLC
• Purity Integrative Health & Wellness Center, PLLC
• Aisha Khan Qadri, MSW
• Aliya Qadri
• Jamie Anne Quinlan, MA, LMHCA, NCC
• David Grant Rasmussen, PSY.D.
• Steven Charles Rautman, PHD
• Rediclinic of Wa, LLC
• Anisa Redmond

• Clinical Psychologist in Mill Creek, WA
• Providers in Mill Creek, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.