Individual provider Active NPI

Afsoon Eftekhari, PH.D.

  • Clinical Psychologist
  • Seattle, WA
National Provider Identifier
1962552034
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY00002918 Issued in WA
Practice address
10740 Meridian Ave N
Suite 110
Seattle, WA 98133-9010
Phone
(206) 931-5686
Fax
(206) 417-8304
NPI assigned
Jan 11, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY00002918 WA Primary

Addresses

Primary practice location

10740 Meridian Ave N
Suite 110
Seattle, WA 98133-9010

Mailing address

10740 Meridian Ave N
Suite 110
Seattle, WA 98133-9010
Phone (206) 931-5686

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

State licenses

LicenseStateTypeSpecialty
PY00002918WAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962552034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10740 MERIDIAN AVE N",
            "address_2": "SUITE 110",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981339010",
            "telephone_number": "206-931-5686",
            "fax_number": "206-417-8304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10740 MERIDIAN AVE N",
            "address_2": "SUITE 110",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981339010",
            "telephone_number": "206-931-5686",
            "fax_number": "206-417-8304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EFTEKHARI",
        "first_name": "AFSOON",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY00002918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.