Heather Amanda De la Fuente, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY61013388 Issued in WA

Practice address

604 NW Richmond Beach Rd
Shoreline, WA 98177-3122

Phone

(206) 533-2900

Fax

(206) 533-2901

NPI assigned

Nov 7, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Clinical Psychologist

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Swedish Health ServicesGroup PAC ID 9537072814, 384 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Swedish Health Services

  • Family Medicine Physician
  • Seattle, WA
  • NPI 1831139724
  Medicare reassignment Care Compare group NPD
• Swedish Health Services

  • Physical Therapist
  • Seattle, WA
  • NPI 1619680840
  NPD

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

{
    "created_epoch": "1541548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1861960890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4476",
            "fax_number": "206-568-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 NW RICHMOND BEACH RD",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981773122",
            "telephone_number": "206-533-2900",
            "fax_number": "206-533-2901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA FUENTE",
        "first_name": "HEATHER",
        "middle_name": "AMANDA",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-07",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY61013388",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY61013388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2146862",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tai Dao, PHARMD
• Guido Inalen Davico, LSWAIC
• Maria Joyce De Araujo Oliveira
• David Philip De Give, M.D.
• Indhira De la Cruz Alcantara, MD
• Roberta J De Vitis, LMHC
• Roxane Mae Decamp, BS, CDPT
• Joshua Decastro, PTA
• Angela Laura Dechand
• Kelsee Chrisine Dees

• Clinical Psychologist in Shoreline, WA
• Providers in Shoreline, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; 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.

Verify at the official NPI Registry.