Active NPI
Kimberly Paige Chadwick, PSY.D.
- Clinical Psychologist
- Tacoma, WA
National Provider Identifier
1609013184
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY00003509
- Practice address
- 9601 Steilacoom Blvd SW
Western State Hospital
Tacoma, WA 98498-7213 - Phone
- (253) 761-3364
- NPI assigned
- Jan 20, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY00003509 | WA | Primary |
Addresses
Primary practice location
9601 Steilacoom Blvd SW
Western State Hospital
Tacoma, WA 98498-7213
Mailing address
9601 Steilacoom Blvd SW
Western State Hospital
Tacoma, WA 98498-7213
Phone (253) 761-6634
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY00003509 | WA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Department of Social Dept of SHS Div of Instns | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Psychiatric Hospital
- Medical Lake, WA
- NPI 1467440602
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1232409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1347408000000",
"number": "1609013184",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9601 STEILACOOM BLVD SW",
"address_2": "WESTERN STATE HOSPITAL",
"city": "TACOMA",
"state": "WA",
"postal_code": "984987213",
"telephone_number": "253-761-6634"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9601 STEILACOOM BLVD SW",
"address_2": "WESTERN STATE HOSPITAL",
"city": "TACOMA",
"state": "WA",
"postal_code": "984987213",
"telephone_number": "253-761-3364"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHADWICK",
"first_name": "KIMBERLY",
"middle_name": "PAIGE",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-01-20",
"last_updated": "2012-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PY00003509",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.