Individual provider Active NPI

Michael Gordon-Tarnowski, AA

  • Counselor
  • Seattle, WA
National Provider Identifier
1255842985
Registry record updated Apr 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
CG60959212 Issued in WA
Practice address
222 Wall St Ste 100
Seattle, WA 98121
Phone
(206) 441-3043
NPI assigned
Oct 20, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X
Counselor 101Y00000X CG60959212 WA Primary

Addresses

Primary practice location

222 Wall St Ste 100
Seattle, WA 98121

Mailing address

222 Wall St Ste 100
Seattle, WA 98121-1431
Phone (206) 441-3043

Other practice location 1

14434 NE 8th St
Bellevue, WA 98007-4146
Phone (425) 223-5126

Other practice location 2

14434 NE 8th St
Bellevue, WA 98007-4146
Phone (425) 223-5126

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
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
CG60959212WAMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1508457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556150400000",
    "number": "1255842985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 WALL ST STE 100",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981211431",
            "telephone_number": "206-441-3043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 WALL ST STE 100",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98121",
            "telephone_number": "206-441-3043"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14434 NE 8th St",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WA",
            "postal_code": "980074146",
            "country_code": "US",
            "telephone_number": "425-223-5126",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14434 NE 8th St",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WA",
            "postal_code": "980074146",
            "country_code": "US",
            "telephone_number": "425-223-5126",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON-TARNOWSKI",
        "first_name": "MICHAEL",
        "credential": "AA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-20",
        "last_updated": "2019-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "CG60959212",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Apr 25, 2019; 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.