Individual provider Active NPI

Jared Simons

  • Counselor
  • Dupont, WA
National Provider Identifier
1154797215
Registry record updated Aug 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
CG60592435 Issued in WA
Practice address
1570 Wilmington Dr Ste 220
Dupont, WA 98327-8773
Phone
(253) 293-5622
NPI assigned
Aug 12, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X CG60592435 WA Primary

Addresses

Primary practice location

1570 Wilmington Dr Ste 220
Dupont, WA 98327-8773

Mailing address

3214 W McGraw St Ste 212
Seattle, WA 98199-3239
Phone (206) 453-4882

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
CG60592435WAMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1439337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439337600000",
    "number": "1154797215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3214 W MCGRAW ST STE 212",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981993239",
            "telephone_number": "206-453-4882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1570 WILMINGTON DR STE 220",
            "city": "DUPONT",
            "state": "WA",
            "postal_code": "983278773",
            "telephone_number": "253-293-5622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONS",
        "first_name": "JARED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-12",
        "last_updated": "2015-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "CG60592435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dupont, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2015; 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.