Active NPI
John Bruce Jessen, PHD
- Clinical Psychologist
- Spokane, WA
National Provider Identifier
1740585025
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY60196969
- Practice address
- 4107 S Bellgrove LN
Spokane, WA 99223-6185 - Phone
- (509) 389-3713
- NPI assigned
- Jan 18, 2011
- Last updated
- Jan 18, 2011
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY60196969 | WA | Primary |
Addresses
Primary practice location
4107 S Bellgrove LN
Spokane, WA 99223-6185
Mailing address
4107 S Bellgrove LN
Spokane, WA 99223-6185
Phone (509) 389-3713
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY60196969 | WA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1295308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295308800000",
"number": "1740585025",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4107 S BELLGROVE LN",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992236185",
"telephone_number": "509-389-3713"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4107 S BELLGROVE LN",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992236185",
"telephone_number": "509-389-3713"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JESSEN",
"first_name": "JOHN",
"middle_name": "BRUCE",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-01-18",
"last_updated": "2011-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PY60196969",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spokane, WA
- Elizabeth Mackenzie Jepson
- Jerry M Johnson Etal PTR Four Seasons Physical Therapy (Four Seasons Physical Therapy)
- Jessi Jeske
- Jesse McCarrell O.D., PS
- Aine Jessel
- Nhung Scarlet Jessen, PA-C
- Jessica Kaluza LLC (Renewed Stories Counseling Services)
- Veronica Jessick, M.D.
- Jessie Harse, MSW LLC (Taproot Psychotherapy)
- Katherine Marie Jessop, LMHC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.