Active NPI
Racquel Anne Shaffer, CAAR
- Peer Specialist
- Tukwila, WA
National Provider Identifier
1205418118
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- CG61096099
- Practice address
- 15455 65TH Ave S
Tukwila, WA 98188-2534 - Phone
- (067) 215-1702
- Fax
- (360) 575-1950
- NPI assigned
- Apr 21, 2021
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | CG61096099 | WA | Primary |
Addresses
Primary practice location
15455 65TH Ave S
Tukwila, WA 98188-2534
Mailing address
PO Box 2429
Longview, WA 98632-8486
Phone (206) 721-5170
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 |
|---|---|---|---|
| CG61096099 | WA | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618963200000",
"number": "1205418118",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2429",
"city": "LONGVIEW",
"state": "WA",
"postal_code": "986328486",
"telephone_number": "206-721-5170",
"fax_number": "360-575-1950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15455 65TH AVE S",
"city": "TUKWILA",
"state": "WA",
"postal_code": "981882534",
"telephone_number": "067-215-1702",
"fax_number": "360-575-1950"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAFFER",
"first_name": "RACQUEL",
"middle_name": "ANNE",
"credential": "CAAR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-21",
"last_updated": "2021-04-21",
"certification_date": "2021-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "WA",
"license": "CG61096099",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tukwila, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.