Organization Active NPI

Siobhan Budwey PHD, PLLC

  • Clinical Psychologist
  • Olympia, WA
National Provider Identifier
1932579364
Registry record updated Sep 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY60302520 Issued in WA
Legal business name
SIOBHAN BUDWEY PHD, PLLC
Doing business as
Siobhan Budwey, PhD
Practice address
324 W Bay Dr NW
Suite 220
Olympia, WA 98502-4926
Phone
(360) 972-5127
Fax
(360) 359-7708
NPI assigned
Sep 28, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2015

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

Authorized official

Name
Dr. Siobhan Budwey, PHDNPI 1992954606
Title
Owner/Licensed Psychologist
Phone
(360) 972-5127

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
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PY60302520 WA Primary

Addresses

Primary practice location

324 W Bay Dr NW
Suite 220
Olympia, WA 98502-4926

Mailing address

324 W Bay Dr NW
Suite 220
Olympia, WA 98502-4926
Phone (360) 972-5127

Other identifiers 1

IdentifierTypeStateIssuer
2038219MedicaidWA

Other names 1

  • Siobhan Budwey, PhD Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151013000847 WA Part B Supplier - Clinic/Group Practice 6901115070 Receives reassigned benefits from 1 practitioner
Practice locations: Olympia, WA

National Provider Directory

National Provider Directory

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": "1443398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443398400000",
    "number": "1932579364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 W BAY DR NW",
            "address_2": "SUITE 220",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985024926",
            "telephone_number": "360-972-5127",
            "fax_number": "360-359-7708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 W BAY DR NW",
            "address_2": "SUITE 220",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985024926",
            "telephone_number": "360-972-5127",
            "fax_number": "360-359-7708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIOBHAN BUDWEY PHD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-28",
        "last_updated": "2015-09-28",
        "status": "A",
        "authorized_official_last_name": "BUDWEY",
        "authorized_official_first_name": "SIOBHAN",
        "authorized_official_title_or_position": "OWNER/LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "360-972-5127",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY60302520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2038219",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Siobhan Budwey, PhD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.