Individual provider Active NPI

Kristin Rochele Gayle, PH.D.

  • Clinical Psychologist
  • Tacoma, WA
National Provider Identifier
1861710204
Registry record updated Apr 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY60129204 Issued in WA
Practice address
9600 Veterans Dr
Tacoma, WA 98493-0001
Phone
(253) 583-1640
NPI assigned
May 10, 2010
Last updated
Apr 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY60129204 WA Primary

Addresses

Primary practice location

9600 Veterans Dr
Tacoma, WA 98493-0001

Mailing address

6642 Stone St SE
Lacey, WA 98513-4961
Phone (360) 701-7281

Other practice location 1

677 Woodland Square Loop SE Ste B6
Lacey, WA 98503-1000
Phone (360) 585-4050

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
I20250716001937 WA Practitioner - Clinical Psychologist 7012422215 Practice locations: Lacey, WA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
LG Psychological Services PLLC CurrentSince Apr 27, 2025 Accepting new patients

Locations

677 Woodland Square Loop SE
Ste B6
Lacey, WA 98503
Phone (360) 585-4050

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1273449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745625600000",
    "number": "1861710204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6642 STONE ST SE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985134961",
            "telephone_number": "360-701-7281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9600 VETERANS DR",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984930001",
            "telephone_number": "253-583-1640"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "677 Woodland Square Loop SE Ste B6",
            "address_purpose": "LOCATION",
            "city": "Lacey",
            "state": "WA",
            "postal_code": "985031000",
            "country_code": "US",
            "telephone_number": "360-585-4050",
            "fax_number": "360-282-1013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAYLE",
        "first_name": "KRISTIN",
        "middle_name": "ROCHELE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-10",
        "last_updated": "2025-04-26",
        "certification_date": "2025-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY60129204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.