Jessica Sue Rose Dillman, CO60579677

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

80-0461504 Issued in WA

Practice address

9720 S Tacoma Way
Lakewood, WA 98499-4456

Phone

(253) 503-3666

Fax

(253) 302-8493

NPI assigned

Jul 31, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1532995200000",
    "number": "1174001341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 3RD ST SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983741109",
            "telephone_number": "253-200-0300",
            "fax_number": "253-302-8493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9720 S TACOMA WAY",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984994456",
            "telephone_number": "253-503-3666",
            "fax_number": "253-302-8493"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3800 3rd St SE",
            "address_purpose": "LOCATION",
            "city": "Puyallup",
            "state": "WA",
            "postal_code": "983741109",
            "country_code": "US",
            "telephone_number": "253-200-0300",
            "fax_number": "253-302-8493",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DILLMAN",
        "first_name": "JESSICA",
        "middle_name": "SUE ROSE",
        "name_prefix": "Miss",
        "credential": "CO60579677",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-31",
        "last_updated": "2018-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "80-0461504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "80-0461504",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charlene Diemandezi, DDS
• Logun Dakota Dienberg
• Christina Dietz
• Lisa Michele Digiacomo, RN
• Shelby Dilley
• Michael David Dimmick, HS
• Ali Dinges
• Christie Ann Dixon Jones
• Amysha Allaquise Dixon, BA
• Lan Doan

• Addiction (Substance Use Disorder) Counselor in Lakewood, WA
• Providers in Lakewood, WA by specialty
• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2018; 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.