NPIMap

Organization Active NPI

Swinomish Indian Tribal Community

Doing business as Swinomish Wellness Program

  • Addiction (Substance Use Disorder) Counselor
  • La Conner, WA
National Provider Identifier
1235689381
Registry record updated Oct 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CO60166467 Issued in WA
Legal business name
SWINOMISH INDIAN TRIBAL COMMUNITY
Doing business as
Swinomish Wellness Program
Practice address
17337 Reservation Rd
La Conner, WA 98257-8802
Phone
(360) 466-1024
Fax
(360) 466-7634
NPI assigned
Oct 12, 2016
Last updated
Oct 12, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2016

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

Authorized official

Name
Jennifer Martin
Title
Biller
Phone
(360) 588-2735

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YA0400X CO60166467 WA Primary

Addresses

Primary practice location

17337 Reservation Rd
La Conner, WA 98257-8802

Mailing address

17337 Reservation Rd
La Conner, WA 98257-8802
Phone (360) 466-1024

Other names 1

  • Swinomish Wellness Program Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Swinomishupper Skagit Dental Clinic10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

17337 Reservation Rd
La Conner, WA 98257
Phone (360) 466-1024

NPI Registry JSON

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

{
    "created_epoch": "1476230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476230400000",
    "number": "1235689381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17337 RESERVATION RD",
            "city": "LA CONNER",
            "state": "WA",
            "postal_code": "982578802",
            "telephone_number": "360-466-1024",
            "fax_number": "360-466-7634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17337 RESERVATION RD",
            "city": "LA CONNER",
            "state": "WA",
            "postal_code": "982578802",
            "telephone_number": "360-466-1024",
            "fax_number": "360-466-7634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SWINOMISH INDIAN TRIBAL COMMUNITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-12",
        "last_updated": "2016-10-12",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "360-588-2735"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CO60166467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Swinomish Wellness Program",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in La Conner, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2016; 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.