Kisela Q Canada

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CO60420771 Issued in WA

Practice address

861 Poplar PL S
Seattle, WA 98144-2827

Phone

(844) 987-9274

NPI assigned

Oct 23, 2018

Last updated

Oct 23, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• For the Culture Counseling Services

  • Substance Abuse Rehabilitation Facility
  • Tacoma, WA
  • NPI 1730787763
  NPD Authorized official

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

{
    "created_epoch": "1540252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540252800000",
    "number": "1083180426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "861 POPLAR PL S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981442827",
            "telephone_number": "844-987-9274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "861 POPLAR PL S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981442827",
            "telephone_number": "844-987-9274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANADA",
        "first_name": "KISELA",
        "middle_name": "Q",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-23",
        "last_updated": "2018-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CO60420771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1006201",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Betty Jo Campnell, CRNA
• Amelia Marie Oliva Campos, M.D.
• Kyla Larissa Tejero Campos
• Anthony Campuzano
• Haley Ann Camuso, PHARMACY TECHNICIAN
• Barbara Lenore Canal, PT
• Lisa Canar, ND
• Joseph Canarelli, LICSW
• Courtney Anne Canavera, M.D.
• Ata Alpay Canbaz, MD

• Addiction (Substance Use Disorder) Counselor in Seattle, WA
• Providers in Seattle, WA by specialty
• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.

Verify at the official NPI Registry.