Active NPI
Sharon Diane Young, PSYD
- Clinical Psychologist
- Issaquah, WA
National Provider Identifier
1750597282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY60026311
- Practice address
- 1700 NW Gilman Blvd
Suite 205
Issaquah, WA 98027-5349 - Phone
- (206) 818-0158
- NPI assigned
- May 14, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | LF00002081 | WA | |
| Clinical Psychologist | 103TC0700X | PY60026311 | WA | Primary |
Addresses
Primary practice location
1700 NW Gilman Blvd
Suite 205
Issaquah, WA 98027-5349
Mailing address
12558 35TH Ave NE Apt B
Seattle, WA 98125-8910
Phone (206) 818-0158
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
- Opted out of Medicare
- Yes, effective Oct 1, 2018 through Oct 1, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY60026311 | WA | MD | Clinical Psychologist |
| LF00002081 | WA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235692800000",
"number": "1750597282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12558 35TH AVE NE APT B",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981258910",
"telephone_number": "206-818-0158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 NW GILMAN BLVD",
"address_2": "SUITE 205",
"city": "ISSAQUAH",
"state": "WA",
"postal_code": "980275349",
"telephone_number": "206-818-0158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "SHARON",
"middle_name": "DIANE",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-14",
"last_updated": "2009-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "WA",
"license": "LF00002081",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PY60026311",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Issaquah, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.