Active NPI
Jason B Johnstone, CDP
- Addiction (Substance Use Disorder) Counselor
- Bonney Lake, WA
National Provider Identifier
1043781024
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- CP60288139
- Practice address
- 10215 214TH Ave E
Bonney Lake, WA 98391-3909 - Phone
- (253) 862-7374
- Fax
- (253) 862-0448
- NPI assigned
- Dec 17, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CP60288139 | WA | Primary |
Addresses
Primary practice location
10215 214TH Ave E
Bonney Lake, WA 98391-3909
Mailing address
13807 69TH Avenue CT E
Puyallup, WA 98373-8721
Phone (253) 691-0398
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CP60288139 | WA | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Freedom Recovery Center LLC | Addiction (Substance Use Disorder) | Past | Accepting new patients |
| New Freedom Recovery Center LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Addiction (Substance Use Disorder) Counselor
- Bonney Lake, WA
- NPI 1487884441
Addiction (Substance Use Disorder)
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Bonney Lake, WA
- NPI 1215352018
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1545004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1545004800000",
"number": "1043781024",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13807 69TH AVENUE CT E",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983738721",
"telephone_number": "253-691-0398"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10215 214TH AVE E",
"city": "BONNEY LAKE",
"state": "WA",
"postal_code": "983913909",
"telephone_number": "253-862-7374",
"fax_number": "253-862-0448"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSTONE",
"first_name": "JASON",
"middle_name": "B",
"credential": "CDP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-12-17",
"last_updated": "2018-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WA",
"license": "CP60288139",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bonney Lake, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.