Phanhmaly Sayasane, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY60855849 Issued in WA

Practice address

9040 Jackson Ave
Joint Base Lewis McChord, WA 98431-1100

Phone

(253) 477-5109

NPI assigned

Dec 18, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Maly Sayasane Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1689737199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040 REID ST # A",
            "city": "JOINT BASE LEWIS MCCHORD",
            "state": "WA",
            "postal_code": "984311100",
            "telephone_number": "253-968-2252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "JOINT BASE LEWIS MCCHORD",
            "state": "WA",
            "postal_code": "984311100",
            "telephone_number": "253-477-5109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAYASANE",
        "first_name": "PHANHMALY",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY60855849",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CO",
            "license": "2543",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALY",
            "last_name": "SAYASANE",
            "credential": "PH.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Vashti Salomon
• Dana Sams, PHYSICIAN ASSISTANT
• Jose A Sanchez, IDMT-PARAMEDIC
• Margaret E Sanchez, PSY.D.
• Jason Elliott Sapp, MD, MHPE
• Mary Cole Amber Sazo
• Adam John Schafer, PA-C
• Alix Schneider, DDS
• Laura Schoolcraft, LCSW
• Johnathon Samuel Schumann, PMHNP

• Clinical Psychologist in Joint Base Lewis McChord, WA
• Providers in Joint Base Lewis McChord, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; 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.