Active NPI
Irmary Rodriguez Rivera
- Clinical Psychologist
- Seattle, WA
National Provider Identifier
1821761115
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY61524546
- Practice address
- 1200 5TH Ave Ste 800
Seattle, WA 98101-3136 - Phone
- (206) 374-0109
- Fax
- (206) 374-0108
- NPI assigned
- Aug 1, 2021
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 071008551 | IL | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Psychologist | 103TC0700X | PY61524546 | WA | Primary |
Addresses
Primary practice location
1200 5TH Ave Ste 800
Seattle, WA 98101-3136
Mailing address
1200 5TH Ave Ste 800
Seattle, WA 98101-3136
Phone (206) 374-0109
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | irodriguez@ebtseattle.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 10, 2024 through Jul 10, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071008551 | IL | MD | Clinical Psychologist |
| PY61524546 | WA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1627776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718928000000",
"number": "1821761115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 5TH AVE STE 800",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981013136",
"telephone_number": "206-374-0109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 5TH AVE STE 800",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981013136",
"telephone_number": "206-374-0109",
"fax_number": "206-374-0108"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ RIVERA",
"first_name": "IRMARY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-01",
"last_updated": "2024-06-21",
"certification_date": "2024-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071008551",
"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": "PY61524546",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "irodriguez@ebtseattle.com",
"affiliation": "N",
"endpointDescription": "email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1200 5th Ave Ste 800",
"city": "Seattle",
"state": "WA",
"country_code": "US",
"postal_code": "981013136",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Seattle, WA
- Patricia A Rodrigues, MD
- Karla Valeria Rodriguez Alanis, MD
- Saul Rodriguez Flores
- Maria Rosario Rodriguez Nava, MA, LMFTA, MHP,CHMS
- Rodolfo Francisco Rodriguez Noalla, DMD
- Zurama Rodriguez Velasquez, APRN
- Yaiel G. Rodriguez-Aviles, MD
- April Elizabeth Rodriguez, ARNP
- Ashley Carmel Rodriguez, CRNP
- Austin Paul Rodriguez
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.