Forensic and Clinical Psychology Services

Primary specialty

PsychologistTaxonomy code 103T00000X

License

754 Issued in WA

Legal business name

FORENSIC AND CLINICAL PSYCHOLOGY SERVICES

Practice address

2820 Northup Way
Suite 250
Bellevue, WA 98004-1419

Phone

(425) 455-2967

NPI assigned

May 29, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Clarence Richard Coder, PHD

Title

Proprietor

Phone

(425) 455-2967

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1369785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369785600000",
    "number": "1770920852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2820 NORTHUP WAY",
            "address_2": "SUITE 250",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980041419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 NORTHUP WAY",
            "address_2": "SUITE 250",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980041419",
            "telephone_number": "425-455-2967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORENSIC AND CLINICAL PSYCHOLOGY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-29",
        "last_updated": "2013-05-29",
        "status": "A",
        "authorized_official_last_name": "CODER",
        "authorized_official_first_name": "CLARENCE",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "PROPRIETOR",
        "authorized_official_telephone_number": "425-455-2967",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "WA",
            "license": "754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2013; 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.