Individual provider Active NPI

Alan M. Haltiner, PHD

  • Clinical Psychologist
  • Seattle, WA
National Provider Identifier
1619048618
Registry record updated May 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY00002000 Issued in WA
Practice address
550 17TH Ave
Fifth Floor
Seattle, WA 98122-5788
Phone
(206) 386-3880
Fax
(206) 386-3882
NPI assigned
Nov 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2021

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 PY00002000 WA Primary

Addresses

Primary practice location

550 17TH Ave
Fifth Floor
Seattle, WA 98122-5788

Mailing address

PO Box 84026
Seattle, WA 98124-8426
Phone (206) 386-3880

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ahaltiner1041823@wm.providencedirect.org Direct

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

LicenseStateTypeSpecialty
PY00002000WAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1619048618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 84026",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981248426",
            "telephone_number": "206-386-3880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 17TH AVE",
            "address_2": "FIFTH FLOOR",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981225788",
            "telephone_number": "206-386-3880",
            "fax_number": "206-386-3882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALTINER",
        "first_name": "ALAN",
        "middle_name": "M.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY00002000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ahaltiner1041823@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "550 17th Ave",
            "address_2": "Fifth Floor",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981225788",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; 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.