Roderick K Mahurin, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PY00002281 Issued in WA

Practice address

8318 196TH St SW
2ND Floor
Edmonds, WA 98026-6434

Phone

(425) 640-5601

NPI assigned

Apr 2, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1700907342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8318 196TH ST SW",
            "address_2": "2ND FLOOR",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980266434",
            "telephone_number": "425-640-5601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8318 196TH ST SW",
            "address_2": "2ND FLOOR",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980266434",
            "telephone_number": "425-640-5601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHURIN",
        "first_name": "RODERICK",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-02",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "WA",
            "license": "PY00002281",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY00002281",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Neuropsychologist in Edmonds, WA
• Providers in Edmonds, WA by specialty
• Clinical Neuropsychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.