NPIMap

Organization Active NPI

Brain Health Northwest

  • Clinical Psychologist
  • Seattle, WA
National Provider Identifier
1669830774
Registry record updated Feb 3, 2016
On this page

Key facts

NPPES NPI Registry
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
Last updated
Feb 3, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2016

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.NPI 1205174679
Title
Psychologist
Phone
(206) 321-1017

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X CL60528100 WA
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 1613 WA Primary

Addresses

Primary practice location

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

Mailing address

219 1St Ave S
Suite 310
Seattle, WA 98104-2575
Phone (206) 321-1017

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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": []
}

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 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.