Individual provider Active NPI

Tamara Odland

  • Mental Health Counselor
  • Port Angeles, WA
National Provider Identifier
1124750906
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
430 E Lauridsen Blvd Ste 112
Port Angeles, WA 98362-7978
Phone
(360) 457-1610
Fax
(360) 457-8650
NPI assigned
Jun 29, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X WA Primary

Addresses

Primary practice location

430 E Lauridsen Blvd Ste 112
Port Angeles, WA 98362-7978

Mailing address

430 E Lauridsen Blvd Ste 112
Port Angeles, WA 98362-7978
Phone (360) 457-1610

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

NPI Registry JSON

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

{
    "created_epoch": "1656460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1124750906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 E LAURIDSEN BLVD STE 112",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983627978",
            "telephone_number": "360-457-1610",
            "fax_number": "360-457-8650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 E LAURIDSEN BLVD STE 112",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983627978",
            "telephone_number": "360-457-1610",
            "fax_number": "360-457-8650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODLAND",
        "first_name": "TAMARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-29",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Angeles, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.

Verify at the official NPI Registry.