Trudy A Iredale, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY00003097 Issued in WA

Practice address

1804 SE 170TH Ave
Vancouver, WA 98683-3474

Phone

(360) 991-0134

Fax

(360) 991-0154

NPI assigned

Dec 28, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

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.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Iredale Professional Services

  • Clinical Psychologist
  • Vancouver, WA
  • NPI 1841811783
  Medicare reassignment NPD Authorized official
• Neurothryve

  • Clinical Psychologist
  • Vancouver, WA
  • NPI 1851835920
  NPD (past)

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597276800000",
    "number": "1770649402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 SE 170TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986833474",
            "telephone_number": "360-991-0134",
            "fax_number": "360-991-0154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 SE 170TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986833474",
            "telephone_number": "360-991-0134",
            "fax_number": "360-991-0154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IREDALE",
        "first_name": "TRUDY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "1597",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY00003097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1770649402",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE II NPI",
            "identifier": "1841811783",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164936",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "trudy@iredaleps.com",
            "affiliation": "N",
            "endpointDescription": "business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1804 SE 170th Ave",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986833474",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Integrity Counseling
• International Rehabilitative Sciences Inc. (RS Medical)
• Interventional Pain Management Associates, Inc
• Invision Eye Care PLLC
• Iredale Professional Services
• Amee Ireland, STUDENT
• Valerie Ann Irvin Phelps, LMT
• Madeline Irwin
• Sande Bartels Irwin, M.D.
• Sara Alison Kaplan Irwin, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.