Brain Health Northwest

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1613 Issued in WA

Legal business name

BRAIN HEALTH NORTHWEST

Practice address

219 1St Ave S
Suite 310
Seattle, WA 98104-2575

Phone

(206) 321-1017

Fax

(206) 641-3246

NPI assigned

Feb 3, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Richard Lynn Packard, PH.D.

Title

Psychologist

Phone

(206) 321-1017

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1454457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454457600000",
    "number": "1669830774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 1ST AVE S",
            "address_2": "SUITE 310",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981042575",
            "telephone_number": "206-321-1017",
            "fax_number": "206-641-3246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 1ST AVE S",
            "address_2": "SUITE 310",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981042575",
            "telephone_number": "206-321-1017",
            "fax_number": "206-641-3246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAIN HEALTH NORTHWEST",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-03",
        "last_updated": "2016-02-03",
        "status": "A",
        "authorized_official_last_name": "PACKARD",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "206-321-1017",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "WA",
            "license": "CL60528100",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "1613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gina Lee Brahy, LMHCA
• Margaret Braidwood, RN
• Kaitlyn Anne Braile, MA, LMHCA
• Ayodale Bukari Braimah, MD
• Brain and Memory Health Group PLLC
• Brain Health USA PC
• Brain Matters Imaging Centers
• Brain Tree, LLC
• Emily Julia Brain, M.ED., BCBA
• Ivana Brajkovic, M.D.

• 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 Feb 3, 2016; 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.