Banji Hazelle Bottcher, CPC

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

CG60474886 Issued in WA

Practice address

325 E Pioneer
Puyallup, WA 98372

Phone

(253) 697-8400

Fax

(253) 697-3730

NPI assigned

Jul 31, 2018

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1532995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557878400000",
    "number": "1124506399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 E PIONEER",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723265",
            "telephone_number": "253-697-8400",
            "fax_number": "253-697-3730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 E PIONEER",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "98372",
            "telephone_number": "253-697-8400",
            "fax_number": "253-697-3730"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1338 Commerce Ave",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "WA",
            "postal_code": "986323732",
            "country_code": "US",
            "telephone_number": "360-623-9272",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1338 Commerce Ave",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "WA",
            "postal_code": "986323732",
            "country_code": "US",
            "telephone_number": "360-623-9272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOTTCHER",
        "first_name": "BANJI",
        "middle_name": "HAZELLE",
        "credential": "CPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-31",
        "last_updated": "2019-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "WA",
            "license": "CG60474886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bonaventure of Puyallup
• Holly Anne Bonnardel, LMFTA
• Nicole Malene Bosch
• Sylvia E Boskovich III
• Jodie Bosma
• Lily Brooks Bottineau-Potter, CBT
• Lynzi Leigh Bouchard
• Karen Boudour, ARNP
• Emily Dianne Boughal, LMT
• Olivia Boughey

• Peer Specialist in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Peer Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.