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NPI 1053749507 · Psychologist · Bellevue, WA
Provider details
- NPI number
- 1053749507
- Entity type
- Organization
- Primary specialty
- PsychologistBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Max Hines, Director(952) 215-1331
- License
- PY00001697 (WA)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Detailed profile(77/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1840 146th Pl Se
Bellevue, WA 98007-6821
Phone: (952) 215-1331
Street-level locationGet directions
Mailing address
1840 146th Pl Se
Bellevue, WA 98007-6821
Registry dates
- Enumerated
- 2013-10-18
- Last updated
- 2013-10-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.