Active NPI
Theresa Marie Buysse, PH.D.
- Psychologist
- Everett, WA
National Provider Identifier
1720423650
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PY00003706
- Practice address
- 3931 Colby Ave
Everett, WA 98201-4926 - Phone
- (425) 249-9618
- NPI assigned
- May 6, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 | PY00003706 | WA | Primary |
| Clinical Child & Adolescent Psychologist | 103TC2200X | PY00003706 | WA |
Addresses
Primary practice location
3931 Colby Ave
Everett, WA 98201-4926
Mailing address
20111 83Rd Ave W
Edmonds, WA 98026-6727
Phone (425) 775-4059
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 |
|---|---|---|---|
| PY00003706 | WA | MD | Clinical Child & Adolescent Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477008000000",
"number": "1720423650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20111 83RD AVE W",
"city": "EDMONDS",
"state": "WA",
"postal_code": "980266727",
"telephone_number": "425-775-4059"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3931 COLBY AVE",
"city": "EVERETT",
"state": "WA",
"postal_code": "982014926",
"telephone_number": "425-249-9618"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUYSSE",
"first_name": "THERESA",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-05-06",
"last_updated": "2016-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WA",
"license": "PY00003706",
"primary": true
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "WA",
"license": "PY00003706",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.