Individual provider Active NPI

Jessica Davis

  • Behavior Technician
  • Bremerton, WA
National Provider Identifier
1003262643
Registry record updated Mar 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
5610 Kitsap Way Ste 320
Bremerton, WA 98312-2266
Phone
(360) 792-2020
NPI assigned
May 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Behavior Technician 106S00000X WA Primary

Addresses

Primary practice location

5610 Kitsap Way Ste 320
Bremerton, WA 98312-2266

Mailing address

3214 W McGraw St
Ste 212
Seattle, WA 98199-3239

Other practice location 1

3214 W McGraw St
Ste 212
Seattle, WA 98199-3239
Phone (206) 453-4882

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Community Services of Western Washington CurrentSince Mar 12, 2023 Accepting new patients

Locations

5610 Kitsap Way
Ste 320
Bremerton, WA 98312
Phone (360) 792-2020

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1463011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1003262643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3214 W MCGRAW ST",
            "address_2": "STE 212",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981993239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5610 KITSAP WAY STE 320",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983122266",
            "telephone_number": "360-792-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3214 W McGraw St",
            "address_2": "Ste 212",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981993239",
            "country_code": "US",
            "telephone_number": "206-453-4882",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-12",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bremerton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.