NPIMap

Individual provider Active NPI

Isaac Stephen Dockter

  • Addiction (Substance Use Disorder) Counselor
  • Renton, WA
National Provider Identifier
1093069296
Registry record updated Nov 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CO60153647 Issued in WA
Practice address
140 Rainier Ave S
Suite 3
Renton, WA 98057-2000
Phone
(425) 255-5526
Fax
(425) 255-5523
NPI assigned
Nov 9, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CO60153647 WA Primary
Mental Health Counselor 101YM0800X CL60174034 WA

Addresses

Primary practice location

140 Rainier Ave S
Suite 3
Renton, WA 98057-2000

Mailing address

140 Rainier Ave S
Suite 3
Renton, WA 98057-2000
Phone (425) 255-5526

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
CO60153647WAMDAddiction (Substance Use Disorder) Counselor
CL60174034WAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1352419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352419200000",
    "number": "1093069296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 RAINIER AVE S",
            "address_2": "SUITE 3",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980572000",
            "telephone_number": "425-255-5526",
            "fax_number": "425-255-5523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 RAINIER AVE S",
            "address_2": "SUITE 3",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980572000",
            "telephone_number": "425-255-5526",
            "fax_number": "425-255-5523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOCKTER",
        "first_name": "ISAAC",
        "middle_name": "STEPHEN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-09",
        "last_updated": "2012-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CO60153647",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "CL60174034",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2012; 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.