Active NPI
Matthew Speltz
- Clinical Child & Adolescent Psychologist
- Seattle, WA
National Provider Identifier
1629159983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- PY00000835
- Practice address
- 4800 Sand Point Way NE
Seattle, WA 98105-3901 - Phone
- (206) 987-2000
- NPI assigned
- Oct 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY00000835 | WA | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | PY00000835 | WA | Primary |
Addresses
Primary practice location
4800 Sand Point Way NE
Seattle, WA 98105-3901
Mailing address
4500 Sand Point Way NE
#100
Seattle, WA 98105-3900
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7783 | Other | INTERNAL ID-MOTOR VEHICLE ID | |
| 8349946 | Medicaid | WA |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY00000835 | WA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1234396800000",
"number": "1629159983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4500 SAND POINT WAY NE",
"address_2": "#100",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981053900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4800 SAND POINT WAY NE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981053901",
"telephone_number": "206-987-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPELTZ",
"first_name": "MATTHEW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-17",
"last_updated": "2009-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PY00000835",
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "WA",
"license": "PY00000835",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INTERNAL ID-MOTOR VEHICLE ID",
"identifier": "7783",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8349946",
"state": "WA"
}
],
"endpoints": [],
"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 Feb 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.