Individual provider Active NPI

Aaron R Burdge, PH.D.

  • Clinical Psychologist
  • Oak Harbor, WA
National Provider Identifier
1730500588
Registry record updated Sep 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY 60032922 Issued in WA
Practice address
32650 State Route 20 Ste E203
Oak Harbor, WA 98277-2686
Phone
(360) 682-6499
NPI assigned
Dec 20, 2013
Last updated
Sep 18, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY 60032922 WA Primary

Addresses

Primary practice location

32650 State Route 20 Ste E203
Oak Harbor, WA 98277-2686

Mailing address

1066 View Ridge Dr
Oak Harbor, WA 98277-8265

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160429001843 WA Practitioner - Clinical Psychologist 7618276361

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY 60032922WAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Alteritas LLC Current Accepting new patients
Bayshore Chiro PC PastSince Nov 1, 2023 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1387497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505692800000",
    "number": "1730500588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1066 VIEW RIDGE DR",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982778265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32650 STATE ROUTE 20 STE E203",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982772686",
            "telephone_number": "360-682-6499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURDGE",
        "first_name": "AARON",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-12-20",
        "last_updated": "2017-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY 60032922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Harbor, WA

Sources for this page

Verify at the official NPI Registry.