Individual provider Active NPI

Andrew Reed Dickens

  • Peer Specialist
  • Mount Vernon, WA
National Provider Identifier
1194296798
Registry record updated Dec 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
1100 S 2ND St
Mount Vernon, WA 98273-4209
Phone
(360) 419-3500
NPI assigned
Dec 8, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X Primary

Addresses

Primary practice location

1100 S 2ND St
Mount Vernon, WA 98273-4209

Mailing address

6410 54TH St NW
Gig Harbor, WA 98335-6649
Phone (253) 225-8457

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

NPI Registry JSON

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

{
    "created_epoch": "1544227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544227200000",
    "number": "1194296798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6410 54TH ST NW",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983356649",
            "telephone_number": "253-225-8457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S 2ND ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982734209",
            "telephone_number": "360-419-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKENS",
        "first_name": "ANDREW",
        "middle_name": "REED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-08",
        "last_updated": "2018-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.