Active NPI
Dennis L Pilgrim, PHD
- Clinical Psychologist
- Vancouver, WA
National Provider Identifier
1760658777
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY60003475
- Practice address
- 9340 NE 76TH St
Vancouver, WA 98662-3721 - Phone
- (360) 253-4912
- Fax
- (360) 253-5170
- NPI assigned
- Apr 30, 2008
- Last updated
- Apr 30, 2008
- Sex
- Male
- Sole proprietor
- No
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 | PY60003475 | WA | Primary |
Addresses
Primary practice location
9340 NE 76TH St
Vancouver, WA 98662-3721
Mailing address
9340 NE 76TH St
Vancouver, WA 98662-3721
Phone (360) 253-4912
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 |
|---|---|---|---|
| 599 | AK | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209513600000",
"number": "1760658777",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9340 NE 76TH ST",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986623721",
"telephone_number": "360-253-4912",
"fax_number": "360-253-5170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9340 NE 76TH ST",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986623721",
"telephone_number": "360-253-4912",
"fax_number": "360-253-5170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PILGRIM",
"first_name": "DENNIS",
"middle_name": "L",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-04-30",
"last_updated": "2008-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PY60003475",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 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.