Neuropsychology and Rehabilitation Services of Washington

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

Legal business name

NEUROPSYCHOLOGY AND REHABILITATION SERVICES OF WASHINGTON

Doing business as

Kelly Cornett

Practice address

1455 NW Leary Way Ste 400a
Seattle, WA 98107-5138

Phone

(425) 209-0828

NPI assigned

Apr 19, 2021

Last updated

Apr 29, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kelly Akiko Cornett, PSYD

Title

Owner/Neuropsychologist

Phone

(425) 209-0828

Specialties & licenses 1

Addresses

Other names 1

• Kelly Cornett Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1618790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619654400000",
    "number": "1912588088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2313 242ND PL SW",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980219349",
            "telephone_number": "425-209-0828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 NW LEARY WAY STE 400A",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981075138",
            "telephone_number": "425-209-0828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROPSYCHOLOGY AND REHABILITATION SERVICES OF WASHINGTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-19",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A",
        "authorized_official_last_name": "CORNETT",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "AKIKO",
        "authorized_official_title_or_position": "OWNER/NEUROPSYCHOLOGIST",
        "authorized_official_telephone_number": "425-209-0828",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "SimplePractice",
            "affiliation": "N",
            "address_1": "1455 NW Leary Way Ste 400A",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981075138",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Kelly Cornett",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kelly Cornett",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Neuropsychologist in Seattle, WA
• Providers in Seattle, WA by specialty
• Clinical Neuropsychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; 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.