Active NPI
Scott Johnson
- Counselor
- Seattle, WA
National Provider Identifier
1063960656
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 122 16TH Ave E
Seattle, WA 98112-5212 - Phone
- (206) 302-2700
- NPI assigned
- Sep 13, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CO60596837 | WA | |
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
122 16TH Ave E
Seattle, WA 98112-5212
Mailing address
6400 Southcenter Blvd
Tukwila, WA 98188-2547
Phone (206) 901-2000
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 |
|---|---|---|---|
| CO60596837 | WA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645488000000",
"number": "1063960656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6400 SOUTHCENTER BLVD",
"city": "TUKWILA",
"state": "WA",
"postal_code": "981882547",
"telephone_number": "206-901-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "122 16TH AVE E",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981125212",
"telephone_number": "206-302-2700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "SCOTT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-09-13",
"last_updated": "2022-02-22",
"certification_date": "2022-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WA",
"license": "CO60596837",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.