Active NPI
Jan M Bestwick, PH.D.
- Forensic Psychologist
- Lynnwood, WA
National Provider Identifier
1578886644
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Forensic Psychologist
- License
- PY 60031165
- Practice address
- 3322 164TH St SW
Lynnwood, WA 98087-3238 - Phone
- (714) 290-4015
- NPI assigned
- Mar 3, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Forensic Psychologist | 103TF0200X | PY 60031165 | WA | Primary |
| Clinical Psychologist | 103TC0700X | PSY 003290 | GA | |
| Clinical Psychologist | 103TC0700X | PY60031165 | WA | |
| Forensic Psychologist | 103TF0200X | PSY003290 | GA |
Addresses
Primary practice location
3322 164TH St SW
Lynnwood, WA 98087-3238
Mailing address
PO Box 5402
Sun City West, AZ 85376-5402
Phone (714) 290-4015
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 003290 | GA | MD | Clinical Psychologist |
| PY60031165 | WA | MD | Clinical Psychologist |
| PSY003290 | GA | MD | Forensic Psychologist |
| PY 60031165 | WA | MD | Forensic Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1267574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1457049600000",
"number": "1578886644",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5402",
"city": "SUN CITY WEST",
"state": "AZ",
"postal_code": "853765402",
"telephone_number": "714-290-4015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3322 164TH ST SW",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980873238",
"telephone_number": "714-290-4015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BESTWICK",
"first_name": "JAN",
"middle_name": "M",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-03-03",
"last_updated": "2016-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "WA",
"license": "PY 60031165",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "GA",
"license": "PSY 003290",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PY60031165",
"primary": false
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "GA",
"license": "PSY003290",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lynnwood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.