Individual provider Active NPI

Dennis Dyck, PH.D.

  • Clinical Psychologist
  • Spokane Valley, WA
National Provider Identifier
1669801015
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY00001596 Issued in WA
Practice address
1415 S Riegel CT
Spokane Valley, WA 99212-3242
Phone
(509) 475-9924
Fax
(877) 992-7014
NPI assigned
Nov 6, 2013
Last updated
Jun 26, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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 PY00001596 WA Primary

Addresses

Primary practice location

1415 S Riegel CT
Spokane Valley, WA 99212-3242

Mailing address

9116 E Sprague Ave # 540
Spokane Valley, WA 99206-4397
Phone (509) 475-9924

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
I20140225002309 WA Practitioner - Clinical Psychologist 9830329572 Practice locations: Spokane Valley, WA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1415 S Riegel CT
Spokane Valley, WA 99212-3242
Phone (509) 475-9924

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1383696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1669801015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9116 E SPRAGUE AVE # 540",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992064397",
            "telephone_number": "509-475-9924",
            "fax_number": "877-992-7014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 S RIEGEL CT",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992123242",
            "telephone_number": "509-475-9924",
            "fax_number": "877-992-7014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYCK",
        "first_name": "DENNIS",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-11-06",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY00001596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane Valley, WA

Sources for this page

Verify at the official NPI Registry.