Active NPI
Wandee Johnson Pryor, PSY.D.
- Clinical Psychologist
- Poulsbo, WA
National Provider Identifier
1831385624
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 60412791
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 60412791 | WA | MD | Clinical Psychologist |
| 24125 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Front Street Clinic Inc | Current | 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.
-
- Psychologist
- Poulsbo, WA
- NPI 1457532913
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Poulsbo, WA
- NPI 1376043232
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2017; 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.