GLEN DAWSON PH.D.
NPI 1992176085
Psychologist in Bothell, WA

Active since October 14, 2015Opted out of Medicare · through Jan 26, 2028
19803 N CREEK PKWY STE 205, BOTHELL, WA 98011(206) 588-5725 Get Directions Write a Review

NPPES record last updated: June 24, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Glen Dawson Ph.d. NPPES

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

GLEN DAWSON PH.D. (NPI 1992176085) is an individual psychologist in Bothell, Washington, licensed in Washington (PY61142927) and active in the NPI registry since October 2015. He has opted out of Medicare through January 26, 2028.

NPPES Registry Identity

NPI1992176085
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameGLEN DAWSONCredential: PH.D.
Location Address19803 N CREEK PKWY STE 205Bothell, WA 98011-5014
Mailing Address19803 N Creek Pkwy Ste 205Bothell, WA 98011-5014 · (206) 588-5725
Sole ProprietorYes
Enumeration DateOctober 14, 2015
Last NPPES UpdateJune 24, 2021
NPPES CertifiedJune 24, 2021
NPI 1992176085 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 · PY61142927
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.
19803 N CREEK PKWY STE 205, Bothell, WA 98011

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Opted out of Medicare

Glen Dawson Ph.d. 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 January 26, 2026 through January 26, 2028.

Opt-Out Effective DateJanuary 26, 2026
Opt-Out In Effect ThroughJanuary 26, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 6

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

Psychologist
19803 N CREEK PKWY STE 205
BOTHELL, WA 98011
Psychologist
19803 N CREEK PKWY STE 205
BOTHELL, WA 98011
Nurse Practitioner
19803 N CREEK PKWY STE 205
BOTHELL, WA 98011
Counselor (Mental Health)
19803 N CREEK PKWY STE 205
BOTHELL, WA 98011
Psychologist
19803 N CREEK PKWY STE 205
BOTHELL, WA 98011
Nurse Practitioner (Psychiatric/Mental Health)
19803 N CREEK PKWY STE 205
BOTHELL, WA 98011

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 Glen Dawson's NPI number?

The NPI number for Glen Dawson is 1992176085. It was assigned to this individual provider in the NPPES registry on October 14, 2015.

Where is Glen Dawson located?

Glen Dawson practices at 19803 N Creek Pkwy Ste 205, Bothell, WA 98011. The listed phone number is (206) 588-5725.

What is Glen Dawson's specialty?

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

Is Glen Dawson enrolled in Medicare?

No. Glen Dawson has opted out of Medicare through January 26, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

What insurance does Glen Dawson accept?

Health plans from Premera Blue Cross Blue Shield of Alaska list Glen Dawson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Glen Dawson was last updated on June 24, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.