Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. W Timm Fredrickson, PHD

Individual provider Psychologist · NPI 1679555411

Dr. W Timm Fredrickson, PHD is a Psychologist in Medical Lake, Washington. Licensed in Washington. Registered with an NPI since 2005.

Licensed in
WA
In the registry since
2005
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

See every abbreviation used in this directory →

Practice location Address checks out

800 W Maple St
Medical Lake, WA 99022-0800
Phone: (509) 299-3121
Fax: (509) 299-7015
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychologist (primary) Taxonomy 103T00000X · Licence PY00001283 (WA)

Record details

NPI number1679555411
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorNo
NPI enumeratedNovember 17, 2005
Last updated in NPPESJuly 13, 2026
Mailing address800 West Maple Street, P O Box 800, Medical Lake, WA 99022-0800

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