Individual provider Active NPI

Joanna Lynn Watson, PHD

  • Clinical Psychologist
  • Seattle, WA
National Provider Identifier
1770018657
Registry record updated Aug 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY60915712 Issued in WA
Practice address
1200 5TH Ave Ste 800
Seattle, WA 98101
Phone
(206) 374-0109
Fax
(206) 374-0108
NPI assigned
Apr 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY60915712 WA Primary

Addresses

Primary practice location

1200 5TH Ave Ste 800
Seattle, WA 98101

Mailing address

1200 5TH Ave Ste 800
Seattle, WA 98101-3136
Phone (206) 374-0109

Other practice location 1

1200 5th Ave Ste 800
Seattle, WA 98101
Phone (206) 374-0109

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 Jul 26, 2019 through Jul 26, 2027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PY60915712WAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1493251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564617600000",
    "number": "1770018657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 5TH AVE STE 800",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981013136",
            "telephone_number": "206-374-0109",
            "fax_number": "206-374-0108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 5TH AVE STE 800",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98101",
            "telephone_number": "206-374-0109",
            "fax_number": "206-374-0108"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 5th Ave Ste 800",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "98101",
            "country_code": "US",
            "telephone_number": "206-374-0109",
            "fax_number": "206-374-0108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATSON",
        "first_name": "JOANNA",
        "middle_name": "LYNN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-27",
        "last_updated": "2019-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY60915712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.