Active NPI
Mylam T. Thai
- Addiction (Substance Use Disorder) Counselor
- Seattle, WA
National Provider Identifier
1225215882
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- CP00005829
- Practice address
- 3639 Martin Luther King Jr Way S
Seattle, WA 98144-6847 - Phone
- (206) 695-7600
- NPI assigned
- Jan 25, 2008
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CP00005829 | WA | Primary |
Addresses
Primary practice location
3639 Martin Luther King Jr Way S
Seattle, WA 98144-6847
Mailing address
3639 Martin Luther King Jr Way S
Seattle, WA 98144-6847
Phone (206) 695-7600
Other practice location 1
3580 Pacific Ave
Tacoma, WA 98418-7915
Phone (253) 798-4500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2111365 | 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 |
|---|---|---|---|
| CP00005829 | 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": "1201219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1542240000000",
"number": "1225215882",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3639 MARTIN LUTHER KING JR WAY S",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981446847",
"telephone_number": "206-695-7600",
"fax_number": "206-695-7606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3639 MARTIN LUTHER KING JR WAY S",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981446847",
"telephone_number": "206-695-7600"
}
],
"practiceLocations": [
{
"address_1": "3580 Pacific Ave",
"address_purpose": "LOCATION",
"city": "Tacoma",
"state": "WA",
"postal_code": "984187915",
"country_code": "US",
"telephone_number": "253-798-4500",
"fax_number": "253-798-4493",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "THAI",
"first_name": "MYLAM",
"middle_name": "T.",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-01-25",
"last_updated": "2018-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WA",
"license": "CP00005829",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2111365",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.