NPIMap

Organization Active NPI

Puget Sound Psychiatric Center

  • Psychiatry Physician
  • Bothell, WA
National Provider Identifier
1841677655
Registry record updated Apr 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
TR60487106 Issued in WA
Legal business name
PUGET SOUND PSYCHIATRIC CENTER
Practice address
10634 E Riverside Dr
Ste. 130
Bothell, WA 98011-3757
Phone
(425) 806-5021
Fax
(425) 486-3949
NPI assigned
Apr 30, 2015
Last updated
Apr 30, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2015

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

Authorized official

Name
Dr. Syed Jamal Mustafe, M.D
Title
Psychiatrist
Phone
(425) 806-5021

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X TR60487106 WA Primary

Addresses

Primary practice location

10634 E Riverside Dr
Ste. 130
Bothell, WA 98011-3757

Mailing address

10634 E Riverside Dr
Ste. 130
Bothell, WA 98011-3757
Phone (425) 806-5021

National Provider Directory

National Provider Directory
Tax ID family
Puget Sound Psychiatric Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1430352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430352000000",
    "number": "1841677655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10634 E RIVERSIDE DR",
            "address_2": "STE. 130",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980113757",
            "telephone_number": "425-806-5021",
            "fax_number": "425-486-3949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10634 E RIVERSIDE DR",
            "address_2": "STE. 130",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980113757",
            "telephone_number": "425-806-5021",
            "fax_number": "425-486-3949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUGET SOUND PSYCHIATRIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-30",
        "last_updated": "2015-04-30",
        "status": "A",
        "authorized_official_last_name": "MUSTAFE",
        "authorized_official_first_name": "SYED",
        "authorized_official_middle_name": "JAMAL",
        "authorized_official_title_or_position": "PSYCHIATRIST",
        "authorized_official_telephone_number": "425-806-5021",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "TR60487106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bothell, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.