Justin Owen Tillery, LMFTA

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFTA.MG.60491723 Issued in WA

Practice address

1212 N Washington St Ste 206
Spokane, WA 99201-2441

Phone

(509) 209-9486

Fax

(509) 232-0883

NPI assigned

Aug 12, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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": "1407801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407801600000",
    "number": "1225447402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "733 E 33RD AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992033127",
            "telephone_number": "503-437-4509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 N WASHINGTON ST STE 206",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992012441",
            "telephone_number": "509-209-9486",
            "fax_number": "509-232-0883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLERY",
        "first_name": "JUSTIN",
        "middle_name": "OWEN",
        "name_prefix": "Mr.",
        "credential": "LMFTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-12",
        "last_updated": "2014-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "MFTA.MG.60491723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kassie May Tillson
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• Tiffany Danielle Timm, BA, RC
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• Marriage & Family Therapist in Spokane, WA
• Providers in Spokane, WA by specialty
• Marriage & Family Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2014; 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.