Individual provider Active NPI

John H Shriner, MSW, LICSW

  • Clinical Social Worker
  • Seattle, WA
National Provider Identifier
1285886911
Registry record updated Mar 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW60238108 Issued in WA
Practice address
1200 12TH Ave S
Pacific Medical Centers
Seattle, WA 98144-2712
Phone
(206) 326-2400
NPI assigned
Oct 13, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X RC00057081 WA
Clinical Social Worker 1041C0700X LW60238108 WA Primary

Addresses

Primary practice location

1200 12TH Ave S
Pacific Medical Centers
Seattle, WA 98144-2712

Mailing address

1200 12TH Ave S
Pacific Medical Centers
Seattle, WA 98144-2712

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jshriner1045283@wm.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121115000381 WA Practitioner - Clinical Social Worker 0648421883 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacmed ClinicsGroup PAC ID 2466350657, 211 clinicians

Practice addresses (Care Compare)

1101 Madison St
Suite 301
Seattle, WA 98104-3599
Phone (206) 505-1300

1200 12TH Ave S
Seattle, WA 98144-2712
Phone (206) 326-2400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RC00057081WAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Pacmed Clinics CurrentSince Sep 10, 2012 Accepting new patients
Pacmed Clinics Current Accepting new patients
Pacmed Clinics CurrentSince Sep 10, 2012 Accepting new patients

Locations

220 15th Ave SE
Puyallup, WA 98372
Phone (253) 435-3400

1200 12th Ave S
Seattle, WA 98144
Phone (206) 326-2400

1101 Madison St
Ste 301
Seattle, WA 98104
Phone (206) 505-1101

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": "1223856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1285886911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 12TH AVE S",
            "address_2": "PACIFIC MEDICAL CENTERS",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981442712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 12TH AVE S",
            "address_2": "PACIFIC MEDICAL CENTERS",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981442712",
            "telephone_number": "206-326-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHRINER",
        "first_name": "JOHN",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-13",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WA",
            "license": "RC00057081",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60238108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jshriner1045283@wm.providencedirect.org",
            "affiliation": "N",
            "address_1": "1200 12th Ave S",
            "address_2": "Pacific Medical Centers",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981442712",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.