Tasha Pedersen, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

219065 Issued in AK

Practice address

1700 Airport Way S
Seattle, WA 98134-1618

Phone

(206) 223-3644

NPI assigned

Sep 18, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

University of Washington School of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kodiak Area Native AssociationGroup PAC ID 8426959297, 36 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Kodiak Area Native Association

  • Community Health Clinic/Center
  • Kodiak, AK
  • NPI 1679514236

  TX

  Medicare reassignment Care Compare group NPD
• Kodiak Area Native Association

  • Dental Clinic/Center
  • Kodiak, AK
  • NPI 1205883907
  NPD (past)
• Kodiak Area Native Association

  • Community Health Clinic/Center
  • Kodiak, AK
  • NPI 1801187471
  NPD (past)

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

{
    "created_epoch": "1568764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1043860380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 7TH AVE NE APT 203",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981054761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 AIRPORT WAY S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981341618",
            "telephone_number": "206-223-3644"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "323 Carolyn St",
            "address_purpose": "LOCATION",
            "city": "Kodiak",
            "state": "AK",
            "postal_code": "996156376",
            "country_code": "US",
            "telephone_number": "907-486-9800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "TASHA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-18",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AK",
            "license": "219065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Lynn Pedegana
• Amanda L Pedersen, PA-C
• Craig A Pedersen, RPH, PHD
• Railey K Pedersen, CMA
• Stephanie Pedersen, DDS
• Ulana Stephanie Pedersen, RPH
• Amelie Pederson
• Brittney Pederson, LMT
• Erin Marie Pederson
• Ian Pediangco

• Clinical Social Worker in Seattle, WA
• Providers in Seattle, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.