Active NPI
Patricia A Matestic, PH.D.
- Clinical Child & Adolescent Psychologist
- Tacoma, WA
National Provider Identifier
1710211479
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- PY60090956
- Practice address
- BLDG 690 Barnes Blvd
Tacoma, WA 98438-7921 - Phone
- (253) 982-1217
- NPI assigned
- Sep 29, 2009
- Sex
- Female
- Sole proprietor
- No
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 Child & Adolescent Psychologist | 103TC2200X | PY60090956 | WA | Primary |
Addresses
Primary practice location
BLDG 690 Barnes Blvd
Tacoma, WA 98438-7921
Mailing address
BLDG 690 Barnes Blvd
McChord AFB, WA 98438
Phone (253) 982-1217
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
| License | State | Type | Specialty |
|---|---|---|---|
| PY60090956 | WA | MD | Clinical Child & Adolescent Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1254182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1745366400000",
"number": "1710211479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "BLDG 690 BARNES BLVD",
"city": "MCCHORD AFB",
"state": "WA",
"postal_code": "98438",
"telephone_number": "253-982-1217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BLDG 690 BARNES BLVD",
"city": "TACOMA",
"state": "WA",
"postal_code": "984387921",
"telephone_number": "253-982-1217"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATESTIC",
"first_name": "PATRICIA",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-09-29",
"last_updated": "2025-04-23",
"certification_date": "2025-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "WA",
"license": "PY60090956",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.