Board-Certified Psychiatrist in Washington
Independent psychiatric consultation via secure telepsychiatry throughout Washington
Structured around diagnostic clarification, second opinions, complex case review, and longitudinal physician-directed care
Clinical Areas of Consultation
Psychiatric Second Opinion
Independent consultation when diagnostic formulation or treatment direction warrants careful reconsideration
Complex Case Consultation
Comprehensive psychiatric evaluation integrating longitudinal history, prior treatment response, laboratory assessment, and genomic analysis when clinically indicated.
Medication Review & Deprescribing
Deliberate evaluation of indication, duration, benefit, and risk — including reduction or discontinuation when indicated.
Substance Use & Addiction Medicine
Comprehensive evaluation of substance use patterns, psychiatric comorbidity, and treatment planning when clinically indicated.
Integrated Medical Evaluation
Assessment of endocrine, inflammatory, metabolic, sleep, and nutritional contributors relevant to psychiatric presentation.
Psychiatric Medication Tapering in Washington
Psychiatric medication tapering is considered when it is clinically appropriate—not assumed. Consultation begins with careful review of diagnosis, treatment response, medication history, previous withdrawal experiences, current evidence, and the patient's goals before individualized recommendations are made.
Representative psychiatric medication classes reviewed during consultation include, but are not limited to:
Includes SSRIs, SNRIs, tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOIs), serotonin modulators, norepinephrine-dopamine reuptake inhibitors (NDRIs), and other atypical antidepressants:
escitalopram (Lexapro), sertraline (Zoloft), fluoxetine (Prozac), paroxetine (Paxil), citalopram (Celexa), fluvoxamine (Luvox), vilazodone (Viibryd), venlafaxine (Effexor XR), desvenlafaxine (Pristiq), duloxetine (Cymbalta), levomilnacipran (Fetzima), bupropion (Wellbutrin XL, Wellbutrin SR), mirtazapine (Remeron), trazodone (Desyrel), vortioxetine (Trintellix), amitriptyline (Elavil), nortriptyline (Pamelor), clomipramine (Anafranil), doxepin (Silenor, Sinequan), phenelzine (Nardil), tranylcypromine (Parnate), isocarboxazid (Marplan), and selegiline transdermal (Emsam).
alprazolam (Xanax), clonazepam (Klonopin), lorazepam (Ativan), diazepam (Valium), oxazepam (Serax), temazepam (Restoril), chlordiazepoxide (Librium), clorazepate (Tranxene), and triazolam (Halcion).
Hypnotic and sleep medications
Includes orexin receptor antagonists, non-benzodiazepine hypnotics, and other prescription sleep medications:
zolpidem (Ambien), eszopiclone (Lunesta), zaleplon (Sonata), doxepin (Silenor), ramelteon (Rozerem), suvorexant (Belsomra), lemborexant (Dayvigo), and daridorexant (Quviviq).
Includes stimulant and non-stimulant medications:
lisdexamfetamine (Vyvanse), mixed amphetamine salts (Adderall IR, Adderall XR), dextroamphetamine (Dexedrine), methylphenidate (Ritalin, Concerta, Metadate CD, Daytrana, Jornay PM, Quillivant XR, QuilliChew ER), dexmethylphenidate (Focalin), atomoxetine (Strattera), guanfacine extended-release (Intuniv), clonidine extended-release (Kapvay), and viloxazine extended-release (Qelbree).
Antipsychotic medications
aripiprazole (Abilify), brexpiprazole (Rexulti), cariprazine (Vraylar), lumateperone (Caplyta), quetiapine (Seroquel), olanzapine (Zyprexa), risperidone (Risperdal), paliperidone (Invega), ziprasidone (Geodon), lurasidone (Latuda), asenapine (Saphris), iloperidone (Fanapt), clozapine (Clozaril), haloperidol (Haldol), chlorpromazine (Thorazine), perphenazine (Trilafon), fluphenazine (Prolixin), loxapine (Loxitane), and thiothixene (Navane).
Mood stabilizers
lithium (Lithobid), lamotrigine (Lamictal), divalproex/valproate (Depakote), carbamazepine (Tegretol), and oxcarbazepine (Trileptal).
Anxiolytic and adjunctive psychiatric medications
buspirone (BuSpar), hydroxyzine (Vistaril, Atarax), clonidine (Catapres), propranolol (Inderal), prazosin (Minipress), gabapentin (Neurontin), and pregabalin (Lyrica).
Medications for opioid use disorder
buprenorphine (Subutex), buprenorphine/naloxone (Suboxone), buprenorphine extended-release (Sublocade, Brixadi), and naltrexone (ReVia, Vivitrol).
Medications for alcohol use disorder
Naltrexone (ReVia, Vivitrol), acamprosate (Campral), and disulfiram (Antabuse).
Our consultation begins with the person, not the medication. Recommendations are individualized based on diagnosis, treatment response, medication history, previous withdrawal experiences, medical history, current evidence, and the patient's goals. Consultation may conclude that continued treatment, medication optimization, transition to an alternative medication, or individualized tapering is the most appropriate course.
Telepsychiatry in Washington
Consultations are conducted via secure video with individuals physically located in Arizona at the time of the visit, in accordance with state licensure requirements.
Care is available statewide, including Spokane, Seattle, Bellevue, Kirkland, Redmond, and surrounding communities, with an emphasis on structured evaluation, diagnostic precision, and continuity of physician-directed care.
Independent psychiatric consultation grounded in diagnostic clarity and longitudinal continuity
