Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

DR. W TIMM FREDRICKSON PHD
NPI 1679555411
Psychologist in Medical Lake, WA

Active since November 17, 2005
800 WEST MAPLE STREET, MEDICAL LAKE, WA 99022(509) 299-3121(509) 299-7015 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. W Timm Fredrickson Phd NPPES

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

DR. W TIMM FREDRICKSON PHD (NPI 1679555411) is an individual psychologist in Medical Lake, Washington, licensed in Washington (PY00001283) and active in the NPI registry since November 2005.

NPPES Registry Identity

NPI1679555411
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameDR. W TIMM FREDRICKSONCredential: PHD
Location Address800 WEST MAPLE STREETMedical Lake, WA 99022-0800
Mailing Address800 West Maple Street, P O Box 800Medical Lake, WA 99022-0800 · (509) 299-3121 · Fax (509) 299-7015
Fax(509) 299-7015
Sole ProprietorNo
Enumeration DateNovember 17, 2005
Last NPPES UpdateJuly 13, 2026
NPI 1679555411 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 · PY00001283
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.

800 WEST MAPLE STREET, Medical Lake, WA 99022

Other Providers at the Same Location NPPES 20

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

Psychologist
800 WEST MAPLE STREET
MEDICAL LAKE, WA 99022
Nurse Practitioner (Psychiatric/Mental Health)
800 WEST MAPLE STREET
MEDICAL LAKE, WA 99022
Psychologist
800 WEST MAPLE STREET
MEDICAL LAKE, WA 99022
Occupational Therapist
800 WEST MAPLE STREET
MEDICAL LAKE, WA 99022
Occupational Therapist
800 WEST MAPLE STREET
MEDICAL LAKE, WA 99022
Family Medicine
800 WEST MAPLE STREET
MEDICAL LAKE, WA 99022
Physical Therapist
800 WEST MAPLE STREET
MEDICAL LAKE, WA 99022
Pharmacist
800 WEST MAPLE STREET
MEDICAL LAKE, WA 99022

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 W Fredrickson's NPI number?

The NPI number for W Fredrickson is 1679555411. It was assigned to this individual provider in the NPPES registry on November 17, 2005.

Where is W Fredrickson located?

W Fredrickson practices at 800 West Maple Street, Medical Lake, WA 99022. The listed phone number is (509) 299-3121.

What is W Fredrickson's specialty?

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

When was this NPI record last updated?

The NPPES record for W Fredrickson was last updated on July 13, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.