Individual provider Active NPI

Charles E. Weisser, PH.D.

  • Psychologist
  • Vancouver, WA
National Provider Identifier
1932156718
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY00001409 Issued in WA
Practice address
754 Officers Row
Vancouver, WA 98661-3845
Phone
(360) 993-2939
Fax
(360) 993-1060
NPI assigned
May 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1409 WA
Clinical Psychologist 103TC0700X 1104 OR
Psychologist 103T00000X PY00001409 WA Primary

Addresses

Primary practice location

754 Officers Row
Vancouver, WA 98661-3845

Mailing address

754 Officers Row
Vancouver, WA 98661-3845
Phone (360) 993-2939

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161031001722 WA Practitioner - Psychologist Billing Independently 6406044114 Practice locations: Vancouver, WA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

754 Officers Row
Vancouver, WA 98661-3845
Phone (360) 993-2939

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1104ORMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Chuck Weisser, PHD. PC Psychologist Current Accepting new patients

Locations

754 Officers Row
Vancouver, WA 98661
Phone (360) 993-2939

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1932156718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "754 OFFICERS ROW",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986613845",
            "telephone_number": "360-993-2939",
            "fax_number": "360-993-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "754 OFFICERS ROW",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986613845",
            "telephone_number": "360-993-2939",
            "fax_number": "360-993-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISSER",
        "first_name": "CHARLES",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "1409",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "1104",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY00001409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.