Mary A Risdon, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY00003582 Issued in WA

Practice address

1808 Richards Rd Ste 105
Bellevue, WA 98005-3982

Phone

(425) 454-7541

NPI assigned

Dec 16, 2006

Sex

Female

Sole proprietor

No

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

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, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

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.

• Pacific Therapy Group, PLLC

  • Community/Behavioral Health Agency
  • Bellevue, WA
  • NPI 1053645754
  Medicare reassignment NPD

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

{
    "created_epoch": "1166227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1891857520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1808 RICHARDS RD STE 105",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980053982",
            "telephone_number": "425-454-7541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1808 RICHARDS RD STE 105",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980053982",
            "telephone_number": "425-454-7541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISDON",
        "first_name": "MARY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-16",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY00003582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelleya Eldoich Ringang, CBT
• Sadie Riopelle, DC
• Dianne C Rios, SCD, OTR/L
• Steve Lars Risa, M.D.
• Rachel Rische
• Aishia Jaqueline Rister, DNP
• Jeremy Ritchey
• Steven W Rittenberg, MD
• Riley Henriksen Ritter
• Annika Ritz

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; 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.