DR. JACQUELINE ANN RANDALL PSY.D.
NPI 1700124781
Psychologist in Seattle, WA
NPI Status: Active since January 25, 2013
Contact Information
3417 EVANSTON AVE N STE 503
SEATTLE, WA
ZIP 98103
Phone: (206) 919-1246
- Individual
- Female
- Psychologist
- PECOS Enrolled
- Opted-Out Medicare
About JACQUELINE RANDALL
This page provides the complete NPI Profile along with additional information for Jacqueline Randall, a provider established in Seattle, Washington with a medical specialization in Psychologist. The healthcare provider is registered in the NPI registry with number 1700124781 assigned on January 2013. The practitioner's primary taxonomy code is 103T00000X with license number PY60503894 (WA). The provider is registered as an individual and her NPI record was last updated one year ago.
- NPI
- 1700124781
- Provider Name
- DR. JACQUELINE ANN RANDALL PSY.D.
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 3417 EVANSTON AVE N STE 503 SEATTLE, WA 98103
- Location Phone
- (206) 919-1246
- Mailing Address
- 600 STEWART ST STE 724 SEATTLE, WA 98101
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 01-25-2013
- Last Update Date
- 02-25-2025
- Code Navigator
A psychologist like Jacqueline Randall studies cognitive, emotional, social processes and behavior by observing, interpreting, and recording how people relate to one another and to their environments. Psychologists gather information and evaluate behavior through controlled laboratory experiments, psychoanalysis, psychotherapy or through personality, performance, aptitude, or intelligence tests, and use this information when testing theories in their research or when treating patients.
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Jacqueline Randall opted out of Medicare effective on 01-01-2016 until 01-01-2026. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare but is permitted to order and refer services to other healthcare providers.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Psychologist
- Taxonomy Code
- 103T00000X
- Type
- Behavioral Health & Social Service Providers
- License No.
- PY60503894
- License State
- WA
- Taxonomy Description
- 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.
Medicare Participation & PECOS Enrollment Status
Jacqueline Randall is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 01-01-2016
Opt-Out End Date: 01-01-2026
Eligible to Order and Refer? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): No
Eligible to Order or Refer Power Mobility Devices: No
Reviews for DR. JACQUELINE ANN RANDALL PSY.D.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 7 | 0 | 0 | 1 | 2 | 4 | 7 | 8 | 1 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 0 | 0 | 2 | 2 | 8 | 7 | 16 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 0 + 0 + 2 + 2 + 8 + 7 + 1 + 6 + 24 = 59 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 59 = 1 | 1 | ||||||||
The NPI number 1700124781 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following provider is registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1902354087 | DR. MARKETA DOLAN PHD Individual | Psychologist (Clinical) | 3417 EVANSTON AVE N STE 503 SEATTLE, WA 98103 (206) 429-5345 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1700124781, enumerated in the NPI registry as an "individual" on January 25, 2013
The provider is located at 3417 Evanston Ave N Ste 503 Seattle, Wa 98103 and the phone number is (206) 919-1246
The provider's speciality is Psychologist with taxonomy code 103T00000X
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).
No, the provider signed an affidavit on January 01, 2016 to opt-out of the Medicare program. The provider is excluded from the Medicare program until January 01, 2026.
This NPI record was last updated on January 25, 2013. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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