Active NPI
Diane S Kaiser, PSY.D.
- Clinical Psychologist
- Vancouver, WA
National Provider Identifier
1689738841
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY2519
- Practice address
- 1701 E Evergreen Blvd
Vancouver, WA 98661-4289 - Phone
- (360) 524-5200
- Fax
- (360) 326-1635
- NPI assigned
- Dec 21, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY2519 | WA | Primary |
Addresses
Primary practice location
1701 E Evergreen Blvd
Vancouver, WA 98661-4289
Mailing address
7720 NE Highway 99 Ste D
Vancouver, WA 98665-8859
Phone (360) 524-5200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 164936 | Medicaid | OR |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY2519 | WA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1573603200000",
"number": "1689738841",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7720 NE HIGHWAY 99 STE D",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986658859",
"telephone_number": "360-524-5200",
"fax_number": "360-326-1635"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1701 E EVERGREEN BLVD",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986614289",
"telephone_number": "360-524-5200",
"fax_number": "360-326-1635"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAISER",
"first_name": "DIANE",
"middle_name": "S",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-21",
"last_updated": "2019-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PY2519",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "164936",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Vancouver, WA
- Kaiser Foundation Health Plan of the Northwest
- Kaiser Foundation Health Plan of the Northwest
- Kaiser Foundation Health Plan of the Northwest
- Kaiser Permanente
- Kaiser Permanente Dental Care Program
- John Kaiser, MD
- Zarko Kajgana, DPM
- Elena Kalantarian, RN
- Kaleidoscope Connections, PLLC
- Kirsten Maria Kalian, LMHC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.