Individual provider Active NPI

Wandee Johnson Pryor, PSY.D.

  • Clinical Psychologist
  • Poulsbo, WA
National Provider Identifier
1831385624
Registry record updated Mar 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
60412791 Issued in WA
Practice address
20174 Front St NE
Poulsbo, WA 98370-7445
Phone
(360) 697-1141
NPI assigned
Sep 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 24125 CA
Clinical Psychologist 103TC0700X 60412791 WA Primary

Addresses

Primary practice location

20174 Front St NE
Poulsbo, WA 98370-7445

Mailing address

P.O. Box 1611
The Front Street Clinic
Poulsbo, WA 98370-7445
Phone (360) 697-1141

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
I20250327003500 WA Practitioner - Clinical Psychologist 2163672353 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Front Street Clinic IncGroup PAC ID 5193612935, 8 clinicians

Practice addresses (Care Compare)

20174 Front St NE
Poulsbo, WA 98370-7445
Phone (360) 697-1141

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60412791WAMDClinical Psychologist
24125CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Front Street Clinic Inc CurrentSince Jan 18, 2025 Accepting new patients
Wandee J. Pryor, Psy.D., LLC Past Accepting new patients

Locations

20174 Front St NE
Poulsbo, WA 98370
Phone (360) 626-9034

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": "1189728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490227200000",
    "number": "1831385624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1611",
            "address_2": "THE FRONT STREET CLINIC",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983707445",
            "telephone_number": "360-697-1141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20174 FRONT ST NE",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983707445",
            "telephone_number": "360-697-1141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRYOR",
        "first_name": "WANDEE",
        "middle_name": "JOHNSON",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-14",
        "last_updated": "2017-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "24125",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "60412791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poulsbo, WA

Sources for this page

Verify at the official NPI Registry.