Puget Sound Psychiatric Services

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

PUGET SOUND PSYCHIATRIC SERVICES

Practice address

10634 E Riverside Dr
Suite 130
Bothell, WA 98011-3757

Phone

(425) 806-5021

NPI assigned

Aug 5, 2007

Organization subpart

No

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

Authorized official

Name

Rebecca Lyn Peterson

Title

Business Manager

Phone

(425) 802-2861

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Puget Sound Psychiatric Center

  • Psychiatry Physician
  • Bothell, WA
  • NPI 1841677655
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Syed Jamal Mustafa, M.D.

  • Psychiatry Physician
  • Bothell, WA
  • NPI 1609883180
  NPD (past)

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214870400000",
    "number": "1902097009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10634 E RIVERSIDE DR",
            "address_2": "SUITE 130",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980113757",
            "telephone_number": "425-806-5021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10634 E RIVERSIDE DR",
            "address_2": "SUITE 130",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980113757",
            "telephone_number": "425-806-5021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUGET SOUND PSYCHIATRIC SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-05",
        "last_updated": "2008-07-01",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "LYN",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "425-802-2861"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1112333",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Logan Prock
• Katherine Fey Proctor, OT
• Jesica C Pruitt, MS, CCC-SLP
• Puget Sound Psychiatric Center
• Puget Sound Psychiatric Center, PS
• Christopher D Pugh, LMHC
• Breanna Elizabeth Purzycki, OTR/L
• Anam R. Qadri
• Huanhuan Qiao
• Xin Qu, LMT

• Psychiatry Physician in Bothell, WA
• Providers in Bothell, WA by specialty
• Psychiatry Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2008; 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.