Ronald J. De Vries, PH.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY1995 Issued in WA

Practice address

16040 Christensen Rd
Suite 212
Tukwila, WA 98188-2934

Phone

(206) 431-5336

Fax

(206) 431-5430

NPI assigned

Feb 7, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Pine Rest Christian Mental Health ServicesGroup PAC ID 4981506508, 354 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Pine Rest Christian Mental Health Services

  • Psychologist
  • Grand Rapids, MI
  • NPI 1780695411
  Medicare reassignment Care Compare group NPD
• Pine Rest Christian Mental Health Services

  • Professional Counselor
  • Grand Rapids, MI
  • NPI 1386015683
  NPD

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790757292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16040 CHRISTENSEN RD",
            "address_2": "SUITE 212",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981882934",
            "telephone_number": "206-431-5336",
            "fax_number": "206-431-5430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16040 CHRISTENSEN RD",
            "address_2": "SUITE 212",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981882934",
            "telephone_number": "206-431-5336",
            "fax_number": "206-431-5430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE VRIES",
        "first_name": "RONALD",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY1995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raleigh Michael Davis
• Wanda Davis, LMHC
• Ahlyn Keuionalani Day, MA
• Charmaine Day
• Erica De Los Reyes, LICSW
• Alexandra Dean
• Robert Dana Dean, DDS
• Daisy Elizabeth Deely, LMHCA
• Stephanie Marie Degroat
• Marin Deifel

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.