DR. KRISTINE RAE VANDERMARK POWELL (NPI# 1477601789) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477601789 |
| Entity Type | Individual |
| Full Name | DR. KRISTINE RAE VANDERMARK POWELL |
| Credential | PSYD |
| Practice Address |
1800 Cooper Point Rd Sw Bldg 17 Olympia WA 98502-1178 |
| Mailing Address |
7825 Canterwood Dr Se Olympia WA 98513-6520 |
| Practice Telephone | 3603524602 |
| Mailing Telephone | 3604593447 |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | PY00002568 | WA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | L AND I | 0157189 | 01 |
| WA | STATE LICENSE | PY00002568 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922265669 | Kristine Melissa Powell | Pediatrics | 8091 Township Line Rd Ste 105, Indianapolis, IN 46260-2495 | 2008-05-20 |
| Street Address |
1800 COOPER POINT RD SW BLDG 17 |
| City | OLYMPIA |
| State | WA |
| Zip Code | 98502-1178 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316930282 | Nancy Jane Sullivan | Social Worker | 1800 Cooper Point Rd Sw, Building 24b, Olympia, WA 98502-1178 | 2005-08-25 |
| 1417480823 | Fabiola Torres Lopez | Behavioral Analyst | 1800 Cooper Point Rd Sw, Bldg. 21, Olympia, WA 98502-1178 | 2017-04-04 |
| 1659810653 | Caroline Gibney | Behavioral Analyst | 1800 Cooper Point Rd Sw, Bldg. 21, Olympia, WA 98502-1178 | 2017-02-23 |
| 1871035105 | Megan Tady | Behavioral Analyst | 1800 Cooper Point Rd Sw, Suite 21, Olympia, WA 98502-1178 | 2016-11-17 |
| 1598217242 | Ashley Nicole Piacenti | Behavioral Analyst | 1800 Cooper Point Rd Sw, Suite 21, Olympia, WA 98502-1178 | 2016-10-28 |
| 1760932180 | Teresa Eucker | Specialist | 1800 Cooper Point Rd Sw, Bldg 2, Olympia, WA 98502-1178 | 2016-10-10 |
| 1417402835 | Leanne Elizabeth Cobb | Behavioral Analyst | 1800 Cooper Point Rd Sw, Suite 21, Olympia, WA 98502-1178 | 2016-08-16 |
| 1275985541 | Paige Hernandez | Behavioral Analyst | 1800 Cooper Point Rd Sw, Building 21, Olympia, WA 98502-1178 | 2016-07-11 |
| 1184076499 | Latoya Evans | Behavioral Analyst | 1800 Cooper Point Rd Sw, Suite 21, Olympia, WA 98502-1178 | 2016-07-11 |
| 1699127092 | Cierra Driscoll | Behavioral Analyst | 1800 Cooper Point Rd Sw, Suite 21, Olympia, WA 98502-1178 | 2016-07-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801409172 | Fanny Cordero | Interpreter | 1415 4th Ave W, Olympia, WA 98502 | 2020-08-26 |
| 1235762832 | Accessible Living Physical Therapy | Clinic/Center | 3524 7th Ave Se, Olympia, WA 98502 | 2020-02-21 |
| 1548807738 | Kaiser Foundation Health Plan of Washington | Pharmacy | 1200 Cooper Point Road Sw, Suite 100, Olympia, WA 98502 | 2019-12-06 |
| 1851946388 | Katherine Ann Vitela | Registered Nurse | 4909 Green Wood Dr Sw, Olympia, WA 98502 | 2019-08-01 |
| 1538632658 | Carmen Rae Breding | Massage Therapist | 2627 Capital Mall Dr Se, Olympia, WA 98502 | 2019-01-11 |
| 1285129155 | Fook Yee Cheung | Genetic Counselor, MS | 2010 Caton Way Sw Ste 102, Olympia, WA 98502 | 2018-06-24 |
| 1942724158 | William Coburn | Specialist/Technologist | 703 Lilly Road Ne, Suite 104, Olympia, WA 98502 | 2017-07-29 |
| 1225567415 | Thierry Buckner | Counselor | 2400 Bristol Court Sw, Olympia, WA 98502 | 2017-06-09 |
| 1619406048 | Trenton Reid | Massage Therapist | 2103 Harrison Ave Nw #2642, Olympia, WA 98502 | 2017-06-08 |
| 1962807305 | Richa Mehta | Dentist | 1530 Black Lake Boulevard, Suite A103, Olympia, WA 98502 | 2014-10-28 |
| Find all providers in zip 98502 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538235908 | Gary Daniel Southwell | Clinical Neuropsychologist | 9643 39th Loop Ne, Olympia, WA 98516-6230 | 2006-11-28 |
| 1194793737 | John Bradford Powell | Clinical Neuropsychologist | 2118 Caton Way Sw, Olympia, WA 98502 | 2006-03-09 |
| 1174796833 | South Sound Neuropsychology Inc. | Clinical Neuropsychologist | 108 22nd Ave Sw, Suite 14, Olympia, WA 98501-2871 | 2008-04-02 |
| 1154408383 | Howard A. Lloyd | Clinical Neuropsychologist | 108 22nd Ave Sw, Suite 14, Olympia, WA 98501-2871 | 2006-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841757010 | Corianne Raychael Lawrence | Clinical Neuropsychologist | 112 N 14th St, Selah, WA 98942-1713 | 2019-02-25 |
| 1588138333 | Mynd Group LLC | Clinical Neuropsychologist | 1066 View Ridge Dr, Oak Harbor, WA 98277-8265 | 2019-01-15 |
| 1588163208 | Johanah Y Kang | Clinical Neuropsychologist | 2013 South 19th Street, Tacoma, WA 98405 | 2018-02-08 |
| 1669850681 | Neuropsychological Services of The South Sound LLC | Clinical Neuropsychologist | 2620 R W Johnson Rd Sw Ste 204, Tumwater, WA 98512-6133 | 2015-05-11 |
| 1710372412 | Daniela Ferdico | Clinical Neuropsychologist | 2101 112th Ave Ne, Suite 100, Bellevue, WA 98004-2944 | 2015-03-31 |
| 1689069502 | Erica K Johnson | Clinical Neuropsychologist | 19000 33rd Ave W Ste 100, Lynnwood, WA 98036-4750 | 2015-03-30 |
| 1659776474 | Rodger Meinz | Clinical Neuropsychologist | 12712 Admiralty Way, B-101, Everett, WA 98204-5562 | 2014-10-23 |
| 1952704413 | Brad Tyson | Clinical Neuropsychologist | 12039 Ne 128th St Fl 3, Kirkland, WA 98034-3029 | 2014-09-29 |
| 1649694662 | Kelly L Crenshaw | Clinical Neuropsychologist | 12 Bellwether Way Ste 240, Bellingham, WA 98225-2959 | 2014-02-11 |
| 1508289299 | Neuropsychology and Cognitive Health | Clinical Neuropsychologist | 1808 Richards Rd #120, Bellevue, WA 98005-3982 | 2014-01-30 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. KRISTINE RAE VANDERMARK POWELL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.