Individual provider Active NPI

Christine Wick, PH.D.

  • Psychologist
  • Seattle, WA
National Provider Identifier
1568673754
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
836 Issued in WA
Practice address
812 Yakima Ave S
Seattle, WA 98144-3145
Phone
(206) 300-0970
NPI assigned
May 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X
Psychologist 103T00000X 836 WA Primary

Addresses

Primary practice location

812 Yakima Ave S
Seattle, WA 98144-3145

Mailing address

812 Yakima Ave S
Seattle, WA 98144-3145
Phone (206) 300-0970

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20041118000728 WA Practitioner - Clinical Psychologist 7810951878 Practice locations: Seattle, WA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of Washington School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

812 Yakima Ave S
Seattle, WA 98144-3145
Phone (206) 300-0970

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
836WAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1180224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1568673754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 YAKIMA AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981443145",
            "telephone_number": "206-300-0970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 YAKIMA AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981443145",
            "telephone_number": "206-300-0970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICK",
        "first_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-27",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.