DR. MENDYANN BOETTCHER MINJAREZ


Address: 4909 25th Ave Ne, Suite 120, Seattle, WA 98105-4107
Phone: 2069877177

DR. MENDYANN BOETTCHER MINJAREZ (NPI# 1699780486) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1699780486
Entity Type Individual
Full Name DR. MENDYANN BOETTCHER MINJAREZ
Credential PH.D.
Practice Address 4909 25th Ave Ne
Suite 120
Seattle
WA 98105-4107
Mailing Address Po Box 5371
M/s Cac (seattle Children's Autism Center)
Seattle
WA 98145-5005
Practice Telephone 2069877177
Practice Fax Number 2069878081
Mailing Telephone 2069877177
Mailing Fax Number 2069878081
Enumeration Date 2006-07-30
Last Update Date 2013-04-29
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 103TC0700X Psychologist
Specialization: Clinical
PSY 20769 CA Behavioral Health & Social Service Providers
Y 103TC0700X Psychologist
Specialization: Clinical
PY 60121906 WA Behavioral Health & Social Service Providers

Office Location

Street Address 4909 25TH AVE NE
SUITE 120
City SEATTLE
State WA
Zip Code 98105-4107

Providers in the same location

NPI Name Taxonomy Address Enumeration
1215952288 Soo-jeong Kim Psychiatry & Neurology 4909 25th Ave Ne, Seattle Childrens Autism Center, Seattle, WA 98105-4107 2006-07-12
1609485242 Jill Jacqueline Locke Psychologist 4909 25th Ave Ne, Seattle, WA 98105-4107 2020-07-29
1043717606 Elizabeth Hatzenbuhler Behavioral Analyst 4909 25th Ave Ne, Seattle, WA 98105-4107 2018-04-10
1730604026 Katelyn Cotter Nurse Practitioner 4909 25th Ave Ne, Seattle, WA 98105-4107 2017-08-07
1083141253 Blayne D Stemple Behavioral Analyst 4909 25th Ave Ne, Seattle, WA 98105-4107 2017-05-17
1295106813 Molly Ewbank Counselor 4909 25th Ave Ne, Seattle, WA 98105-4107 2015-10-08
1568833184 Kelley Cade Counselor 4909 25th Ave Ne, Suite 120, Seattle, WA 98105-4107 2015-10-08
1114398872 Seattle Children's Hospital Counselor 4909 25th Ave Ne, Seattle, WA 98105-4107 2015-10-07
1467828772 Tara Godinho Behavioral Analyst 4909 25th Ave Ne, Suite 120, Seattle, WA 98105-4107 2015-08-20
1386050748 Eunice Barron Behavioral Analyst 4909 25th Ave Ne, Seattle, WA 98105-4107 2014-07-07
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1326662396 Dale Justin Podolsky Student in an Organized Health Care Education/Training Program 4800 Sand Point Way Ne, Ob.9.520, Seattle Children's, Seattle, WA 98105 2020-06-04
1376170878 Andrew Crompton Yazman Pediatrics 4800 Sand Point Way, Ne Oc.7.830, Seattle, WA 98105 2020-03-25
1427688845 Daniela Michell Zepeda Behavioral Analyst 4616 25th Ave Ne Pmb 437, Seattle, WA 98105 2020-01-24
1255981189 Emily King Student in an Organized Health Care Education/Training Program Mark Hawkins, Pa-c, Mpas, 4311 11th Ave Ne Suite 200, WA 98105 2019-09-12
1821659327 Sara Katherine Horne Student in an Organized Health Care Education/Training Program 4800 Sand Point Way Ne, Mb.11.500, Department of Anesthesiology and Pain Medicine, Seattle, Seattle, WA 98105 2019-06-25
1881252575 Darryl Lee Wright Peer Specialist Gossett Place, 4719 12th Ave Ne, Seattle, WA 98105 2019-05-29
1487117891 Nirupama Madhavan Behavioral Analyst 5001 25th Ave Ne, Seattle, WA 98105 2019-04-11
1780155648 Eryn R Mcentee Naturopath 2216 Ne46th St, Seattle, WA 98105 2018-12-17
1356811921 Kyle Leland Bernbach Massage Therapist 5224 Ravenna Ave Ne, Seattle, WA 98105 2018-11-27
1548742380 Janal Kim Physician Assistant 4726 11th Ave Ne, Apt 511, Seattle, WA 98105 2018-08-29
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Taxonomy Information

Taxonomy Code 103TC0700X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Clinical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1346841442 Jeanette Lee Chong Psychologist 2112 3rd Ave N Unit C, Seattle, WA 98109-2304 2020-11-04
1295355923 Douglas M Wear Psychologist 5802 16th Ave Ne, Seattle, WA 98105-2517 2020-04-22
1659910057 Caitlin Stanaway Psychologist 7615 S 134th St, Seattle, WA 98178-5112 2020-01-02
1407495211 Ellen A. Begley, Ph.d. Pllc Psychologist 3417 Fremont Ave N Ste 316, Seattle, WA 98103-3411 2019-12-26
1649735580 Jennifer Savion Psychologist 2800 E Madison St Ste 306, Seattle, WA 98112-4865 2019-02-05
1073084935 Ann Marie Roepke Psychologist 4741 Rainier Ave S, Seattle, WA 98118-1657 2018-12-17
1801399431 Jessica Lynn Peterson Psychologist Chdd 1701 Ne Columbia Rd Seattle Wa 98195, Seattle, WA 98195-0001 2018-03-09
1144676842 Alisa Horwitz Psychologist 2855 31st Ave W, Seattle, WA 98199-2722 2016-05-11
1982065611 Sara Eagan Psychologist 2470 Westlake Ave N Ste 102, Seattle, WA 98109 2016-03-08
1679933899 Yu Ding Psychologist 330 3rd Ave W, 520, Seattle, WA 98119-4180 2016-03-01
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Competitor

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City SEATTLE
Zip Code 98105

Improve Information

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Dataset Information

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.

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