Active NPI
Joel Stephen Eppig, PHD
- Clinical Neuropsychologist
- Seattle, WA
National Provider Identifier
1649849670
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- PY61131319
- Practice address
- 415 1St Ave N
Seattle, WA 98109-4744 - Phone
- (206) 859-5030
- NPI assigned
- Jun 23, 2021
- 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 | PY61131319 | WA | |
| Clinical Neuropsychologist | 103G00000X | PY61131319 | WA | Primary |
Addresses
Primary practice location
415 1St Ave N
Seattle, WA 98109-4744
Mailing address
3329 E Marion St
Seattle, WA 98122-5100
Phone (443) 417-3587
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
| License | State | Type | Specialty |
|---|---|---|---|
| PY61131319 | WA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624406400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632960000000",
"number": "1649849670",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3329 E MARION ST",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981225100",
"telephone_number": "443-417-3587"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 1ST AVE N",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981094744",
"telephone_number": "206-859-5030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EPPIG",
"first_name": "JOEL",
"middle_name": "STEPHEN",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-06-23",
"last_updated": "2021-09-30",
"certification_date": "2021-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PY61131319",
"primary": false
},
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "WA",
"license": "PY61131319",
"primary": true
}
],
"identifiers": [],
"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 Sep 30, 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.