Individual provider Active NPI

Dujin Baek, CDPT

  • Addiction (Substance Use Disorder) Counselor
  • Tacoma, WA
National Provider Identifier
1295299378
Registry record updated Jan 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CO60872575 Issued in WA
Practice address
721 Fawcett Ave Ste 201
Tacoma, WA 98402-5502
Phone
(253) 306-2412
Fax
(253) 593-2396
NPI assigned
Jan 23, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CO60872575 WA Primary

Addresses

Primary practice location

721 Fawcett Ave Ste 201
Tacoma, WA 98402-5502

Mailing address

721 Fawcett Ave Ste 201
Tacoma, WA 98402-5502
Phone (253) 306-2412

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

State licenses

LicenseStateTypeSpecialty
CO60872575WAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1548201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548201600000",
    "number": "1295299378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 FAWCETT AVE STE 201",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984025502",
            "telephone_number": "253-306-2412",
            "fax_number": "253-593-2396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 FAWCETT AVE STE 201",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984025502",
            "telephone_number": "253-306-2412",
            "fax_number": "253-593-2396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAEK",
        "first_name": "DUJIN",
        "credential": "CDPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-23",
        "last_updated": "2019-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CO60872575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.