NPIMap

Individual provider Active NPI

Dana Marklund Tharaldsen, CDPT / AAC

  • Counselor
  • Port Ludlow, WA
National Provider Identifier
1073166294
Registry record updated Sep 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
CO60218608 Issued in WA
Practice address
7701 Oak Bay Rd
Port Ludlow, WA 98365-9634
Phone
(360) 643-1801
NPI assigned
Jul 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X CO60218608 WA Primary

Addresses

Primary practice location

7701 Oak Bay Rd
Port Ludlow, WA 98365-9634

Mailing address

7701 Oak Bay Rd
Port Ludlow, WA 98365-9634

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

LicenseStateTypeSpecialty
CO60218608WAMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Madrona Institute of Washington PastSince Jul 25, 2019 Accepting new patients
Jefferson Community Counseling Center PastSince Jul 25, 2019 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/discoverybh/r4/

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.

NPI Registry JSON

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

{
    "created_epoch": "1563321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1073166294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7701 OAK BAY RD",
            "city": "PORT LUDLOW",
            "state": "WA",
            "postal_code": "983659634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7701 OAK BAY RD",
            "city": "PORT LUDLOW",
            "state": "WA",
            "postal_code": "983659634",
            "telephone_number": "360-643-1801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKLUND THARALDSEN",
        "first_name": "DANA",
        "credential": "CDPT / AAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-17",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "CO60218608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Ludlow, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2019; 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.