Colleen T Peck, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

00020132 Issued in WA

Practice address

36116 SE 89TH PL
Snoqualmie, WA 98065-9789

Phone

(425) 301-9856

NPI assigned

Mar 19, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Colleen T Peck MD PLLC

  • Psychiatry Physician
  • Snoqualmie, WA
  • NPI 1639688427

  Psychiatry

  NPD Authorized official
• Rainier State School

  • Intellectual Disabilities Intermediate Care Facility
  • Buckley, WA
  • NPI 1164547626
  NPD Authorized official
• Washington State Department of Social and Health Services

  • Long Term Care Pharmacy
  • Buckley, WA
  • NPI 1740355320
  NPD

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

{
    "created_epoch": "1616112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616112000000",
    "number": "1831775980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36116 SE 89TH PL",
            "city": "SNOQUALMIE",
            "state": "WA",
            "postal_code": "980659789",
            "telephone_number": "425-301-9856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36116 SE 89TH PL",
            "city": "SNOQUALMIE",
            "state": "WA",
            "postal_code": "980659789",
            "telephone_number": "425-301-9856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "COLLEEN",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-19",
        "last_updated": "2021-03-19",
        "certification_date": "2020-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "00020132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miy Yong Obrian, PHARM.D
• Jorge Luis Orozco
• Grace Kay Owen, RN
• Chitralekha Pasupuleti, M.D
• Shilpa M Patel, DPT, OCS
• Daesoleil Peterson Henry
• Nikole Le Pham
• Physiotherapy Associates, Inc.
• Taylor Pitts, RN
• Sarah Poeschl, PT

• All providers in Snoqualmie, WA
• Psychiatry Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.