NPIMap

Organization Active NPI

Psychiatric Wellness & Dementia Care,LLC

  • Clinic/Center
  • Lynnwood, WA
National Provider Identifier
1912244377
Registry record updated Jan 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
AP60122579 Issued in WA
Legal business name
PSYCHIATRIC WELLNESS & DEMENTIA CARE,LLC
Practice address
20102 Cedar Valley Rd Ste 107
Lynnwood, WA 98036-6333
Phone
(206) 459-1158
NPI assigned
Jan 4, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2013

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

Authorized official

Name
Dr. Tatiana Sadak, ARNP.PHDNPI 1235466517
Title
Owner
Phone
(206) 459-1158

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X AP60122579 WA Primary

Addresses

Primary practice location

20102 Cedar Valley Rd Ste 107
Lynnwood, WA 98036-6333

Mailing address

20102 Cedar Valley Rd Ste 107
Lynnwood, WA 98036-6333
Phone (206) 459-1158

National Provider Directory

National Provider Directory

Locations

20102 Cedar Valley Rd
Ste 107
Lynnwood, WA 98036
Phone (206) 459-1158

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1357257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357257600000",
    "number": "1912244377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20102 CEDAR VALLEY RD STE 107",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980366333",
            "telephone_number": "206-459-1158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20102 CEDAR VALLEY RD STE 107",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980366333",
            "telephone_number": "206-459-1158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHIATRIC WELLNESS & DEMENTIA CARE,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-04",
        "last_updated": "2013-01-04",
        "status": "A",
        "authorized_official_last_name": "SADAK",
        "authorized_official_first_name": "TATIANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-459-1158",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ARNP.PHD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WA",
            "license": "AP60122579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2013; 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.