Active NPI
Amber Tabares, PH.D.
- Clinical Psychologist
- Bellevue, WA
National Provider Identifier
1780905331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY 60084158
- Practice address
- 1750 112TH Ave NE Ste D161
Bellevue, WA 98004-3727 - Phone
- (206) 612-1390
- NPI assigned
- Jun 17, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PY 60084158 | WA | |
| Clinical Psychologist | 103TC0700X | PY 60084158 | WA | Primary |
| Clinical Child & Adolescent Psychologist | 103TC2200X | PY 60084158 | WA |
Addresses
Primary practice location
1750 112TH Ave NE Ste D161
Bellevue, WA 98004-3727
Mailing address
1750 112TH Ave NE Ste D161
Bellevue, WA 98004-3727
Phone (206) 612-1390
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY 60084158 | WA | MD | Clinical Child & Adolescent Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1276732800000",
"number": "1780905331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1750 112TH AVE NE STE D161",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980043727",
"telephone_number": "206-612-1390"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1750 112TH AVE NE STE D161",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980043727",
"telephone_number": "206-612-1390"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TABARES",
"first_name": "AMBER",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-06-17",
"last_updated": "2010-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WA",
"license": "PY 60084158",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PY 60084158",
"primary": true
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "WA",
"license": "PY 60084158",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bellevue, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.