Keith Sonnanburg, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY 1704 Issued in WA

Practice address

1818 Westlake Ave N
Suite 122
Seattle, WA 98109-2777

Phone

(206) 654-3338

NPI assigned

Jan 16, 2007

Last updated

Jun 10, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

University of Washington School of Medicine, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654819200000",
    "number": "1982756631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11700 MUKILTEO SPEEDWAY # 201-1225",
            "city": "MUKILTEO",
            "state": "WA",
            "postal_code": "982755432",
            "telephone_number": "206-817-9145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 WESTLAKE AVE N",
            "address_2": "SUITE 122",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981092777",
            "telephone_number": "206-654-3338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONNANBURG",
        "first_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY 1704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monica Lynn Soni, MD, MSC
• Sheeba Soni
• Sonia Kim Takasaki DMD PLLC
• Angela Louise Sonia
• Jessica Garner Sonkin, PA-C
• Megan Aiko Sono, PHARM.D.
• Sonodiagnostics, LLC
• Clayton John Sontheimer, M.D.
• Annemiek Maria Sontrop, M.D.
• Sonu Mathur DDS PLLC

• Clinical Psychologist in Seattle, WA
• Providers in Seattle, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.