Matthew Ralph De Haan, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

60337257 Issued in WA

Practice address

16000 Bothell Everett Hwy
Suite 340
Mill Creek, WA 98012-1742

Phone

(425) 780-7184

NPI assigned

Sep 9, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1283990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433203200000",
    "number": "1578870648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 216TH ST SW",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980217528",
            "telephone_number": "619-307-1420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16000 BOTHELL EVERETT HWY",
            "address_2": "SUITE 340",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980121742",
            "telephone_number": "425-780-7184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE HAAN",
        "first_name": "MATTHEW",
        "middle_name": "RALPH",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-09",
        "last_updated": "2015-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "60337257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald Eugene Davis, LMP
• Steven A Davis, OD
• Alison K. Day, MA, CCC-SLP
• Katherine A. C. Day
• Sara Maria Day
• Melanie Diane Dilger De la Cantera, RN, BSN, IBCLC
• Cheryl De Roca, M.A., M.S.
• Holly D Debevoise
• Kristin Dedeaux, D.C.
• Karen Mitrakul Deguzman

• 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 Jun 2, 2015; 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.