Active NPI
Jonathan W Anderson, PHD
- Clinical Neuropsychologist
- Spokane, WA
National Provider Identifier
1871744375
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- PY60001677
- Practice address
- 711 S Cowley St
Spokane, WA 99202-1330 - Phone
- (509) 473-6159
- NPI assigned
- Oct 2, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | PY60001677 | WA | Primary |
| Clinical Psychologist | 103TC0700X | PY60001677 | WA |
Addresses
Primary practice location
711 S Cowley St
Spokane, WA 99202-1330
Mailing address
711 S Cowley St
Spokane, WA 99202-1330
Phone (509) 473-6159
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY60001677 | WA | MD | Clinical Neuropsychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301356800000",
"number": "1871744375",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "711 S COWLEY ST",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992021330",
"telephone_number": "509-473-6159"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "711 S COWLEY ST",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992021330",
"telephone_number": "509-473-6159"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "JONATHAN",
"middle_name": "W",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-10-02",
"last_updated": "2011-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "WA",
"license": "PY60001677",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PY60001677",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.