Sue Ann Birdwell, MA, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

RC00047944 Issued in WA

Practice address

15422 164TH Ave NE
Woodinville, WA 98072-8994

Phone

(206) 778-8759

Fax

(425) 806-2919

NPI assigned

May 7, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720291909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15422 164TH AVE NE",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "980728994",
            "telephone_number": "206-778-8759",
            "fax_number": "425-806-2919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15422 164TH AVE NE",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "980728994",
            "telephone_number": "206-778-8759",
            "fax_number": "425-806-2919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRDWELL",
        "first_name": "SUE ANN",
        "name_prefix": "Mrs.",
        "credential": "MA, MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "RC00047944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.