Northwest Fishing Partner Registry

Primary specialty

Recreation TherapistTaxonomy code 225800000X

Legal business name

NORTHWEST FISHING PARTNER REGISTRY

Practice address

9028 11TH PL W
Everett, WA 98204-2693

Phone

(206) 325-7700

NPI assigned

Apr 5, 2019

Organization subpart

No

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

Authorized official

Name

Sean Kiaer, CAPT.

Title

Commodore

Phone

(206) 325-7700

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• NorthWest Fishing Partners Other name

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

{
    "created_epoch": "1554422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554422400000",
    "number": "1154883338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9028 11TH PL W",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982042693",
            "telephone_number": "206-325-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9028 11TH PL W",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982042693",
            "telephone_number": "206-325-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST FISHING PARTNER REGISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-05",
        "last_updated": "2019-04-05",
        "status": "A",
        "authorized_official_last_name": "KIAER",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "COMMODORE",
        "authorized_official_telephone_number": "206-325-7700",
        "authorized_official_credential": "CAPT."
    },
    "taxonomies": [
        {
            "code": "225800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Recreation Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF WASHINGTON SECRETARY OF STATE",
            "identifier": "604-116-958",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NorthWest Fishing Partners",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Recreation Therapist in Everett, WA
• Providers in Everett, WA by specialty
• Recreation Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 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.