John M Gottman
Individual provider Active NPI Counseling Psychologist · Deer Harbor, WA
NPI 1982134714 · NPPES record last updated Jun 14, 2017
Key facts
- NPI
- 1982134714
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counseling Psychologist 103TC1900X
- License
- PY00001562 (WA)
- Practice address
- 1689 Spring Point Rd
Deer Harbor, WA 98243-9824 - Phone
- (206) 313-0471
- NPI assigned
- Jun 14, 2017
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY00001562 | WA | MD | Counseling Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gottman Private Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | PY00001562 | WA | Yes |
Addresses
Primary practice location
1689 Spring Point Rd
Deer Harbor, WA 98243-9824
Mailing address
PO Box 304
Deer Harbor, WA 98243-0304
Other providers in Deer Harbor, WA
All providers in Deer Harbor, WA · Counseling Psychologist in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 14, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.