DR. MARY JOSEPHINE HENDRICKSON (PHD) – Psychologist, NPI 1699755561
Psychologist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
775 CLINICAL PSYCHOLOGIST in WA
Provider Addresses for DR. MARY JOSEPHINE HENDRICKSON (PHD)
16040, Christensen Road, Tukwila, King County, Washington, 98188, United States
STE 212
TUKWILA, WA 98188
Phone: (206) 431-5336
Fax: (206) 431-5430
Type: Mailing
22500 SE 64TH PL STE 230
ISSAQUAH, WA 980278111
Phone: (425) 409-6414
Fax: (425) 409-6618
Type: Mailing
5825, 221st Place Southeast, Issaquah, King County, Washington, 98027, United States
STE 201
ISSAQUAH, WA 98027
Phone: (206) 431-5336
Fax: (425) 391-7014
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2023-06-30
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20230630002809 | I | Clinical Psychologist | WA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 98188)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | OR | |
| - | WA | |
| Clinical Social Worker | OR | |
| Nurse Practitioner | TX | |
| - | OR | |
| Nurse Practitioner | OR | |
| Mental Health Counselor | OR | |
| Clinical Social Worker | OR | |
| Mental Health Counselor | OR | |
| Mental Health Counselor | TX |
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