DR. KENNETH A SHULTZ EDD
NPI 1285818732
Psychologist in Vancouver, WA

Active since December 19, 2007Opted out of Medicare · through Oct 1, 2026
7600 NE 41ST ST, #310, VANCOUVER, WA 98662(360) 567-1665(360) 253-3196 Get Directions Write a Review

NPPES record last updated: December 19, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Kenneth A Shultz Edd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KENNETH A SHULTZ EDD (NPI 1285818732) is an individual psychologist in Vancouver, Washington, licensed in Washington (PY760) and active in the NPI registry since December 2007. He has opted out of Medicare through October 1, 2026 and remains eligible to order and refer.

NPPES Registry Identity

NPI1285818732
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameDR. KENNETH A SHULTZCredential: EDD
Location Address7600 NE 41ST ST, #310Vancouver, WA 98662-6728
Mailing Address7600 Ne 41st St, #310Vancouver, WA 98662-6728 · (360) 567-1665 · Fax (360) 253-3196
Fax(360) 253-3196
Sole ProprietorYes
Enumeration DateDecember 19, 2007
NPI 1285818732 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in WA · PY760
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
7600 NE 41ST ST, Vancouver, WA 98662

Other Identifiers 2

Medicare UPINUPINR11692WA
Medicare PINGAB25690WA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Dr. Kenneth A Shultz Edd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 1, 2016 through October 1, 2026.

Opt-Out Effective DateOctober 1, 2016
Opt-Out In Effect ThroughOctober 1, 2026Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychologist (Forensic)
7600 NE 41ST ST, SUITE 310
VANCOUVER, WA 98662
Psychologist (Clinical)
7600 NE 41ST ST, SUITE 310
VANCOUVER, WA 98662
Nurse Practitioner (Psychiatric/Mental Health)
7600 NE 41ST ST, SUITE 310
VANCOUVER, WA 98662
Psychologist (Clinical)
7600 NE 41ST ST, SUITE 310
VANCOUVER, WA 98662
Psychologist
7600 NE 41ST ST, #310
VANCOUVER, WA 98662
Nurse Practitioner (Psychiatric/Mental Health)
7600 NE 41ST ST, SUITE 310
VANCOUVER, WA 98662
Social Worker (Clinical)
7600 NE 41ST ST
VANCOUVER, WA 98662
Nurse Practitioner (Psychiatric/Mental Health)
7600 NE 41ST ST, SUITE 310
VANCOUVER, WA 98662

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kenneth Shultz's NPI number?

The NPI number for Kenneth Shultz is 1285818732. It was assigned to this individual provider in the NPPES registry on December 19, 2007.

Where is Kenneth Shultz located?

Kenneth Shultz practices at 7600 NE 41st St #310, Vancouver, WA 98662. The listed phone number is (360) 567-1665.

What is Kenneth Shultz's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Kenneth Shultz enrolled in Medicare?

No. Kenneth Shultz has opted out of Medicare through October 1, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Kenneth Shultz was last updated on December 19, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.