Active NPI
Jarniful Mustafa Abdul Razek, THW000111369
- Peer Specialist
- Kennewick, WA
National Provider Identifier
1063206217
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- THW000111369
- Practice address
- 3321 W Kennewick Ave Ste 150
Kennewick, WA 99336-2968 - Phone
- (872) 985-5026
- NPI assigned
- Apr 4, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | 111369 | OR | |
| Peer Specialist | 175T00000X | THW000111369 | OR | Primary |
Addresses
Primary practice location
3321 W Kennewick Ave Ste 150
Kennewick, WA 99336-2968
Mailing address
3321 W Kennewick Ave Ste 150
Kennewick, WA 99336-2968
Other practice location 1
605 SE Ceser Estrada Chavez Blvd,
Portland, OR 97214
Phone (872) 985-5026
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 |
|---|---|---|---|
| 111369 | OR | MD | Peer Specialist |
| THW000111369 | OR | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1743724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743724800000",
"number": "1063206217",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3321 W KENNEWICK AVE STE 150",
"city": "KENNEWICK",
"state": "WA",
"postal_code": "993362968"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3321 W KENNEWICK AVE STE 150",
"city": "KENNEWICK",
"state": "WA",
"postal_code": "993362968",
"telephone_number": "872-985-5026"
}
],
"practiceLocations": [
{
"address_1": "605 SE Ceser Estrada Chavez Blvd,",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "97214",
"country_code": "US",
"telephone_number": "872-985-5026",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ABDUL RAZEK",
"first_name": "JARNIFUL",
"middle_name": "MUSTAFA",
"credential": "THW000111369",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-04-04",
"last_updated": "2025-04-04",
"certification_date": "2025-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "OR",
"license": "111369",
"primary": false
},
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "OR",
"license": "THW000111369",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kennewick, WA
- A Part of Our Family
- A.J.a.N Afh LLC
- Omar Uriel Abarca
- Abc Optometric Services Inc (Clearwater Family Eye Care)
- Laili Abd Latif, MS RD CD
- Abdullah Alkanan BDS PLLC
- Ibrahim A Abdulrahman, MD
- Drew S Ableman, DO
- Accident Care Chiropractic PC (Accident Care Chiropractic of Kennewick)
- Christine A Acker, ARNP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.