Fredrica A Rostad
Individual provider Active NPI Psychologist · Orting, WA
NPI 1831436161 · NPPES record last updated Jan 7, 2013
Key facts
- NPI
- 1831436161
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- 273193C (WA)
- Practice address
- 320 Washington Ave N
Orting, WA 98360-8404 - Phone
- (360) 893-2246
- NPI assigned
- Jan 7, 2013
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 273193C | WA | MD | Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 273193C | WA | Yes |
Addresses
Primary practice location
320 Washington Ave N
Orting, WA 98360-8404
Mailing address
320 Washington Ave N
Orting, WA 98360-8404
Phone (360) 893-2246
Other providers in Orting, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 7, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.