Individual provider Active NPI

Jessica Latortue

  • Peer Specialist
  • Vancouver, WA
National Provider Identifier
1174284301
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
10604 NE Highway 99
Vancouver, WA 98686-5613
Phone
(360) 644-1631
NPI assigned
Jan 10, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Peer Specialist 175T00000X Primary

Addresses

Primary practice location

10604 NE Highway 99
Vancouver, WA 98686-5613

Mailing address

10604 NE Highway 99
Vancouver, WA 98686-5613

Other practice location 1

2700 Simpson Ave
Aberdeen, WA 98520-4335
Phone (360) 612-0012

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

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Wellness PastSince Jan 1, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1641772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1174284301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10604 NE HIGHWAY 99",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986865613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10604 NE HIGHWAY 99",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986865613",
            "telephone_number": "360-644-1631"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2700 Simpson Ave",
            "address_purpose": "LOCATION",
            "city": "Aberdeen",
            "state": "WA",
            "postal_code": "985204335",
            "country_code": "US",
            "telephone_number": "360-612-0012",
            "fax_number": "360-532-0670",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LATORTUE",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-10",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; 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.