Nathaniel John Jungbluth, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY60373417 Issued in WA

Practice address

19803 North Creek Pkwy
Suite 205
Bothell, WA 98011

Phone

(425) 954-6038

NPI assigned

Sep 5, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Interoperability endpoints

• Direct secure messaging: njungbluth13962@direct.seattlechildrens.org

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

{
    "created_epoch": "1378339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531267200000",
    "number": "1750716155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19803 NORTH CREEK PKWY",
            "address_2": "SUITE 205",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "98011",
            "telephone_number": "425-954-6038",
            "fax_number": "425-481-2157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19803 NORTH CREEK PKWY",
            "address_2": "SUITE 205",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "98011",
            "telephone_number": "425-954-6038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNGBLUTH",
        "first_name": "NATHANIEL",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-05",
        "last_updated": "2018-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY60373417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yaeji Jong
• Mansi Joshi
• Yuri V Jouravlev, LMP
• Olivia Maria Juarez
• Amrita Kaur Juneja
• Carrie Kaeter
• Kaiser Foundation Health Plan of Washington (Northshore Medical Center)
• Kaiser Foundation Health Plan of Washington (Kaiser Permanente Northshore Pharmacy)
• Wai Kwan Kam
• Cassandra Dawn Kaminski, LMP

• Clinical Psychologist in Bothell, WA
• Providers in Bothell, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.