Travis L Osborne, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY00003492 Issued in WA

Practice address

1200 5TH Ave Ste 800
Seattle, WA 98101-3136

Phone

(206) 374-0109

NPI assigned

May 23, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2016 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

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.

• Evidence Based Treatment Centers of Seattle

  • Community/Behavioral Health Agency
  • Seattle, WA
  • NPI 1083882260
  NPD (past)
• Evidence Based Treatment Centers of Seattle, PLLC

  • Group Psychotherapy Psychologist
  • Seattle, WA
  • NPI 1144436312

  Clinical

  NPD (past)

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578441600000",
    "number": "1649480906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 5TH AVE STE 800",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981013136",
            "telephone_number": "206-374-0109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 5TH AVE STE 800",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981013136",
            "telephone_number": "206-374-0109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSBORNE",
        "first_name": "TRAVIS",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2020-01-08",
        "certification_date": "2020-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY00003492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Osborne
• Jennifer Osborne
• Kathryn Lee Osborne, ARNP
• Kyle Osborne, DC
• Samuel Osborne
• Maureen Oscadal, RN, MPH, BSN
• Kristine Sy Osea, ARNP, DNP
• Fabiola Osegueda
• Violeta Osegueda, MD
• Joanne Lynn Osetsky, ARNP

• Clinical Psychologist in Seattle, WA
• Providers in Seattle, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.