Tiffany Koenigsaecker, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY 60279425 Issued in WA

Practice address

9601 Steilacoom Blvd SW
Lakewood, WA 98498-7212

Phone

(253) 984-4158

NPI assigned

Oct 24, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Tiffany Steur Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Department of Social Dept of SHS Div of Instns

  dba Eastern State Hospital

  • Psychiatric Hospital
  • Medical Lake, WA
  • NPI 1467440602
  NPD (past)

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

{
    "created_epoch": "1477267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477267200000",
    "number": "1700337946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13205 96TH AVENUE CT E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983735528",
            "telephone_number": "818-298-9738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9601 STEILACOOM BLVD SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984987212",
            "telephone_number": "253-984-4158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOENIGSAECKER",
        "first_name": "TIFFANY",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-24",
        "last_updated": "2016-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY 60279425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "STEUR",
            "prefix": "DR.",
            "credential": "PSY.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Psychologist in Lakewood, WA
• Providers in Lakewood, WA by specialty
• Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.