Nina De Lacy, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

MD 60482456 Issued in WA

Practice address

1959 NE Pacific St
Box 356560
Seattle, WA 98195-6560

Phone

(206) 543-3750

NPI assigned

Apr 14, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Christina Roberts Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1302739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468281600000",
    "number": "1932499670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "468 NOE ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941142016",
            "telephone_number": "650-704-4230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST",
            "address_2": "BOX 356560",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981956560",
            "telephone_number": "206-543-3750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LACY",
        "first_name": "NINA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-14",
        "last_updated": "2016-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "WA",
            "license": "MD 60482456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "ROBERTS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Manuel De la Garza
• Amalia De la Iglesia
• Maria Teresa De la Morena, MD
• Juan De la Ossa, M.D.
• Erica J De la Riva
• Ann L. De Lancey, PH.D.
• Carla Marcela De Leon Gonzalez, NATUROPATHIC DOCTOR
• Rualdo Ruben De Leon Polanco
• Claire Quintos De Leon, LMHC
• Glecy Guevarra De Leon, RN

• Child & Adolescent Psychiatry Physician in Seattle, WA
• Providers in Seattle, WA by specialty
• Child & Adolescent Psychiatry Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2016; 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.