Active NPI
David Jeffery Mashburn, PH.D.
- Clinical Psychologist
- Bellevue, WA
National Provider Identifier
1902938418
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1216
- Practice address
- 1715 114TH Ave SE
Suite 200
Bellevue, WA 98004-6945 - Phone
- (206) 340-9600
- NPI assigned
- Mar 10, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1216 | WA | Primary |
Addresses
Primary practice location
1715 114TH Ave SE
Suite 200
Bellevue, WA 98004-6945
Mailing address
1715 114TH Ave SE
Suite 200
Bellevue, WA 98004-6945
Phone (206) 340-9600
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1902938418",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1715 114TH AVE SE",
"address_2": "SUITE 200",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980046945",
"telephone_number": "206-340-9600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1715 114TH AVE SE",
"address_2": "SUITE 200",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980046945",
"telephone_number": "206-340-9600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASHBURN",
"first_name": "DAVID",
"middle_name": "JEFFERY",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "1216",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bellevue, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.