Debra Lynn Talley, PSY.D.
Individual provider Active NPI Clinical Psychologist · Twisp, WA
NPI 1770810202 · NPPES record last updated Nov 4, 2009
Key facts
- NPI
- 1770810202
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PY60114590 (WA)
- Practice address
- 111B Twisp River Rd
Twisp, WA 98856-9787 - Phone
- (509) 429-0019
- NPI assigned
- Nov 4, 2009
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170509002442 | OR | Practitioner - Clinical Psychologist | 9234416850 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY60114590 | WA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DHS/Office of Financial Services Irs/Eopc/BMRC/Eotc/Osh/Osh-P | Current |
Accepting new patients |
Locations
29398 Recovery Way
Junction City, OR 97448
Phone (503) 945-2800
2600 Center St NE
Salem, OR 97301
Phone (503) 945-2800
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY60114590 | WA | Yes |
Addresses
Primary practice location
111B Twisp River Rd
Twisp, WA 98856-9787
Mailing address
P.O. Box 366
Twisp, WA 98856
Phone (509) 429-0019
Other providers in Twisp, WA
- Thomas Fraser Robinson
- Shaun C Seibel
- Margaret Annarose Shean
- Sarah Lea Simmons
- Christina Stout
- The Wild Clinic, PLLC
- Jamie J Thomson
- Katherine Emily Tilley
- Ulrich Valley Pharmacy Inc
- Christine Ann Ulrich
All providers in Twisp, WA · Clinical Psychologist in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 4, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.