Active NPI
James Raymond Watts, SUDP
- Addiction (Substance Use Disorder) Counselor
- Snoqualmie, WA
National Provider Identifier
1164044715
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- CP61101667
- Practice address
- 9575 Ethan Wade Way SE
Snoqualmie, WA 98065-9577 - Phone
- (425) 831-5425
- Fax
- (425) 831-5428
- NPI assigned
- May 16, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CP61101667 | WA | Primary |
Addresses
Primary practice location
9575 Ethan Wade Way SE
Snoqualmie, WA 98065-9577
Mailing address
PO Box 969
Attn James Watts
Snoqualmie, WA 98065-0969
Phone (425) 831-5425
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2220356 | Medicaid | WA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| CP61101667 | WA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1589587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675382400000",
"number": "1164044715",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 969",
"address_2": "ATTN JAMES WATTS",
"city": "SNOQUALMIE",
"state": "WA",
"postal_code": "980650969",
"telephone_number": "425-831-5425"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9575 ETHAN WADE WAY SE",
"city": "SNOQUALMIE",
"state": "WA",
"postal_code": "980659577",
"telephone_number": "425-831-5425",
"fax_number": "425-831-5428"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATTS",
"first_name": "JAMES",
"middle_name": "RAYMOND",
"credential": "SUDP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-05-16",
"last_updated": "2023-02-03",
"certification_date": "2023-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WA",
"license": "CP61101667",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2220356",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Snoqualmie, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.