Individual provider Active NPI

Ellen Ethington, PSY.D.

  • Clinical Psychologist
  • Spokane, WA
National Provider Identifier
1609977750
Registry record updated Jan 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3263 Issued in WA
Practice address
9507 N Division St
Ste F
Spokane, WA 99218-1553
Phone
(509) 456-3600
Fax
(509) 747-4420
NPI assigned
Sep 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 3263 WA Primary

Addresses

Primary practice location

9507 N Division St
Ste F
Spokane, WA 99218-1553

Mailing address

9507 N Division St
Ste F
Spokane, WA 99218-1553
Phone (509) 456-3600

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
I20120621000281 WA Practitioner - Clinical Psychologist 9638333792 Practice locations: Spokane, WA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2011 N Madison St
Spokane, WA 99205-4412
Phone (509) 218-5145

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3263WAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Optic One Eye Care Centers of Spokane PC 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.

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516579200000",
    "number": "1609977750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9507 N DIVISION ST",
            "address_2": "STE F",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992181553",
            "telephone_number": "509-456-3600",
            "fax_number": "509-747-4420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9507 N DIVISION ST",
            "address_2": "STE F",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992181553",
            "telephone_number": "509-456-3600",
            "fax_number": "509-747-4420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETHINGTON",
        "first_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2018-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "3263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.