Individual provider Active NPI

Sharon Xie, PHD

  • Psychologist
  • Kirkland, WA
National Provider Identifier
1740720135
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
60668316 Issued in WA
Practice address
11703 NE 80TH St
Unit D4
Kirkland, WA 98033-8126
Phone
(206) 331-5515
NPI assigned
Mar 3, 2017
Last updated
Sep 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 60668316 WA Primary

Addresses

Primary practice location

11703 NE 80TH St
Unit D4
Kirkland, WA 98033-8126

Mailing address

4915 25TH Ave NE Ste 102W
Seattle, WA 98105-5667
Phone (206) 257-0134

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Dec 12, 2023 through Dec 12, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
60668316WAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Under One Roof Psychological Services Psychologist CurrentSince Sep 11, 2022 Accepting new patients

Locations

4915 25th Ave NE
Ste 102W
Seattle, WA 98105
Phone (206) 257-0134

Organizations & group practices 1

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": "1488499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1740720135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4915 25TH AVE NE STE 102W",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981055667",
            "telephone_number": "206-257-0134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11703 NE 80TH ST",
            "address_2": "UNIT D4",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980338126",
            "telephone_number": "206-331-5515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "XIE",
        "first_name": "SHARON",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-03",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "60668316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

Verify at the official NPI Registry.