Thomas Osterdahl, CDP

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CP60725651 Issued in WA

Practice address

7935 Lake Ballinger Way
Edmonds, WA 98026-9166

Phone

(425) 412-2973

Fax

(425) 672-6022

NPI assigned

Dec 10, 2018

Last updated

Dec 10, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1544400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544400000000",
    "number": "1003387580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7935 LAKE BALLINGER WAY",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980269166",
            "telephone_number": "425-412-2973",
            "fax_number": "425-672-6022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7935 LAKE BALLINGER WAY",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980269166",
            "telephone_number": "425-412-2973",
            "fax_number": "425-672-6022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSTERDAHL",
        "first_name": "THOMAS",
        "credential": "CDP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-12-10",
        "last_updated": "2018-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP60725651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Edmonds, WA
• Providers in Edmonds, WA by specialty
• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2018; 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.