Active NPI
Maryanne Staigers Trause, PHD
- Psychologist
- Olympia, WA
National Provider Identifier
1942378906
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 2617 12TH CT SW Ste B5
Olympia, WA 98502-1023 - Phone
- (360) 352-1750
- Fax
- (360) 352-7881
- NPI assigned
- Nov 30, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | Primary |
Addresses
Primary practice location
2617 12TH CT SW Ste B5
Olympia, WA 98502-1023
Mailing address
PO Box 11009
Olympia, WA 98508-1009
Phone (360) 352-2037
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7028798 | Medicaid | WA | |
| 0227339 | Other | WA | LABOR AND INDUSTRIES |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199404800000",
"number": "1942378906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 11009",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985081009",
"telephone_number": "360-352-2037",
"fax_number": "360-352-0637"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2617 12TH CT SW STE B5",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985021023",
"telephone_number": "360-352-1750",
"fax_number": "360-352-7881"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAUSE",
"first_name": "MARYANNE",
"middle_name": "STAIGERS",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-30",
"last_updated": "2008-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7028798",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR AND INDUSTRIES",
"identifier": "0227339",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
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 Jan 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.