Individual provider Active NPI

Robert Anthony Welch, PH.D.

  • Marriage & Family Therapist
  • Port Angeles, WA
National Provider Identifier
1831249960
Registry record updated Aug 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
020705 LF00000963 Issued in WA
Practice address
3080 Lower Elwha Rd
Port Angeles, WA 98363-8411
Phone
(360) 452-8471
Fax
(360) 457-8429
NPI assigned
Jan 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 020705 LF00000963 WA Primary

Addresses

Primary practice location

3080 Lower Elwha Rd
Port Angeles, WA 98363-8411

Mailing address

518 W Lauridsen Blvd
Port Angeles, WA 98362-7511
Phone (360) 582-4868

Other identifiers 1

IdentifierTypeStateIssuer
1980937MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20240102000152 WA Practitioner - Marriage and Family Therapist 6507216710 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jamestown S'Klallam TribeGroup PAC ID 2365349495, 38 clinicians

Practice addresses (Care Compare)

808 N 5TH Ave
Sequim, WA 98382-3045
Phone (360) 683-5900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
020705 LF00000963WAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jamestown S'Klallam Tribe CurrentSince Jan 1, 2024 Accepting new patients
Jamestown S'Klallam Tribe CurrentSince Jan 1, 2024 Accepting new patients

Locations

526 S 9th Ave
Sequim, WA 98382
Phone (360) 681-7755

808 N 5th Ave
Sequim, WA 98382
Phone (360) 582-4840

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439251200000",
    "number": "1831249960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "518 W LAURIDSEN BLVD",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983627511",
            "telephone_number": "360-582-4868",
            "fax_number": "360-582-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3080 LOWER ELWHA RD",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983638411",
            "telephone_number": "360-452-8471",
            "fax_number": "360-457-8429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELCH",
        "first_name": "ROBERT",
        "middle_name": "ANTHONY",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2015-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "020705 LF00000963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1980937",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Angeles, WA

Sources for this page

Verify at the official NPI Registry.