Individual provider Active NPI

Edyta Anna Skarbek, PH.D.

  • Clinical Psychologist
  • Seattle, WA
National Provider Identifier
1700969524
Registry record updated Sep 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY 00003812 Issued in WA
Practice address
1660 S Columbian Way,
Pshcs, Mail Stop: S - 116 - DDTP
Seattle, WA 98108
Phone
(206) 764-2163
NPI assigned
Oct 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2008

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY 00003812 WA Primary
Addiction (Substance Use Disorder) Psychologist 103TA0400X PY 00003812 WA
Cognitive & Behavioral Psychologist 103TB0200X PY 00003812 WA
Psychologist 103T00000X PY 00003812 WA
Group Psychotherapy Psychologist 103TP2701X PY 00003812 WA

Addresses

Primary practice location

1660 S Columbian Way,
Pshcs, Mail Stop: S - 116 - DDTP
Seattle, WA 98108

Mailing address

224 Pontius Ave N
Apt. # 302
Seattle, WA 98109-5418
Phone (206) 624-0299

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY 00003812WAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222214400000",
    "number": "1700969524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 PONTIUS AVE N",
            "address_2": "APT. # 302",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981095418",
            "telephone_number": "206-624-0299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 S COLUMBIAN WAY,",
            "address_2": "PSHCS, MAIL STOP: S - 116 - DDTP",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98108",
            "telephone_number": "206-764-2163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKARBEK",
        "first_name": "EDYTA",
        "middle_name": "ANNA",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2008-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY 00003812",
            "primary": true
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "PY 00003812",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "WA",
            "license": "PY 00003812",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY 00003812",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "WA",
            "license": "PY 00003812",
            "primary": false
        }
    ],
    "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 Sep 24, 2008; 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.