Individual provider Active NPI

Daniel Jass

  • Marriage & Family Therapist
  • Vancouver, WA
National Provider Identifier
1285067397
Registry record updated Jan 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LF60444661 Issued in WA
Practice address
1601 E 4TH Plain Blvd Ste A152
Vancouver, WA 98661-3713
Phone
(564) 397-7686
NPI assigned
Aug 12, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Marriage & Family Therapist 106H00000X LF60444661 WA Primary

Addresses

Primary practice location

1601 E 4TH Plain Blvd Ste A152
Vancouver, WA 98661-3713

Mailing address

11217 NE 148TH Ave
Vancouver, WA 98682-2006
Phone (651) 485-8430

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LF60444661WAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lifeline Connections CurrentSince Jan 1, 2024 Accepting new patients
Lifeline Connections Current Accepting new patients
Lifeline Connections Medical Services CurrentSince Jan 1, 2024 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/lifelineconnections/r4/

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1376265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546387200000",
    "number": "1285067397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11217 NE 148TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986822006",
            "telephone_number": "651-485-8430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 E 4TH PLAIN BLVD STE A152",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986613713",
            "telephone_number": "564-397-7686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JASS",
        "first_name": "DANIEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-12",
        "last_updated": "2019-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "LF60444661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.