Active NPI
Rebecca Gabrielle Stoller, PH.D
- Psychologist
- Seattle, WA
National Provider Identifier
1740454149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 2489
- Practice address
- 3216 NE 45TH PL Ste 100
Seattle, WA 98105-4028 - Phone
- (206) 505-9474
- NPI assigned
- Apr 16, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 2489 | WA | Primary |
Addresses
Primary practice location
3216 NE 45TH PL Ste 100
Seattle, WA 98105-4028
Mailing address
5735 31St Ave NE
Seattle, WA 98105-2318
Phone (206) 505-9474
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 |
|---|---|---|---|
| 2489 | WA | MD | Sports Physician Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208304000000",
"number": "1740454149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5735 31ST AVE NE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981052318",
"telephone_number": "206-505-9474"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3216 NE 45TH PL STE 100",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981054028",
"telephone_number": "206-505-9474"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOLLER",
"first_name": "REBECCA",
"middle_name": "GABRIELLE",
"credential": "PH.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-04-16",
"last_updated": "2008-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WA",
"license": "2489",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.