Active NPI
Aya Demar, PHD
- Clinical Psychologist
- Renton, WA
National Provider Identifier
1710562947
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY60894200
- Practice address
- 911 N 10TH PL
Renton, WA 98057-0009 - Phone
- (425) 391-5700
- Fax
- (425) 391-5701
- NPI assigned
- Mar 9, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PY60894200 | WA | |
| Clinical Psychologist | 103TC0700X | PY60894200 | WA | Primary |
Addresses
Primary practice location
911 N 10TH PL
Renton, WA 98057-0009
Mailing address
PO Box 25608
Salt Lake City, UT 84125-0608
Phone (206) 320-4476
Other practice location 1
1730 Minor Ave Ste 400
Seattle, WA 98101-2402
Phone (206) 320-2961
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2269335 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY60894200 | WA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615248000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706832000000",
"number": "1710562947",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 25608",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841250608",
"telephone_number": "206-320-4476",
"fax_number": "206-568-7043"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "911 N 10TH PL",
"city": "RENTON",
"state": "WA",
"postal_code": "980570009",
"telephone_number": "425-391-5700",
"fax_number": "425-391-5701"
}
],
"practiceLocations": [
{
"address_1": "1730 Minor Ave Ste 400",
"address_purpose": "LOCATION",
"city": "Seattle",
"state": "WA",
"postal_code": "981012402",
"country_code": "US",
"telephone_number": "206-320-2961",
"fax_number": "206-710-9013",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DEMAR",
"first_name": "AYA",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-09",
"last_updated": "2024-02-02",
"certification_date": "2024-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WA",
"license": "PY60894200",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PY60894200",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2269335",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Renton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.