Individual provider Active NPI

Andrea N. R. Hartman, PSYD

  • Clinical Psychologist
  • Seattle, WA
National Provider Identifier
1790174209
Registry record updated Apr 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY60881065 Issued in WA
Practice address
Seattle Children'S Hospital
4800 Sand Point Way NE, Ms Oa.5.154
Seattle, WA 98105
Phone
(206) 987-2164
NPI assigned
Jan 21, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Psychologist 103TC0700X PY60881065 WA Primary

Addresses

Primary practice location

Seattle Children'S Hospital
4800 Sand Point Way NE, Ms Oa.5.154
Seattle, WA 98105

Mailing address

Seattle Children'S Hospital
4800 Sand Point Way NE, Ms Oa.5.154
Seattle, WA 98105
Phone (206) 987-2164

Other practice location 1

3250 Wilshire Blvd Fl 5
Los Angeles, CA 90010-1577
Phone (323) 361-3849

Other practice location 2

422 N Meridian St
V342
Newberg, OR 97132-2699
Phone (503) 869-6821

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY60881065WAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1421798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587081600000",
    "number": "1790174209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SEATTLE CHILDREN'S HOSPITAL",
            "address_2": "4800 SAND POINT WAY NE, MS OA.5.154",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98105",
            "telephone_number": "206-987-2164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SEATTLE CHILDREN'S HOSPITAL",
            "address_2": "4800 SAND POINT WAY NE, MS OA.5.154",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98105",
            "telephone_number": "206-987-2164"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3250 Wilshire Blvd Fl 5",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900101577",
            "country_code": "US",
            "telephone_number": "323-361-3849",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "422 N Meridian St",
            "address_2": "V342",
            "address_purpose": "LOCATION",
            "city": "Newberg",
            "state": "OR",
            "postal_code": "971322699",
            "country_code": "US",
            "telephone_number": "503-869-6821",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARTMAN",
        "first_name": "ANDREA",
        "middle_name": "N. R.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-21",
        "last_updated": "2020-04-17",
        "certification_date": "2020-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY60881065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2020; 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.