Active NPI
Reilly Rosbotham
- Counselor
- Tacoma, WA
National Provider Identifier
1306386958
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- CG60739906
- Practice address
- 610 Yakima Ave
Tacoma, WA 98405-4851 - Phone
- (253) 396-5246
- NPI assigned
- Mar 1, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | CG60739906 | WA | Primary |
Addresses
Primary practice location
610 Yakima Ave
Tacoma, WA 98405-4851
Mailing address
2109 N Alder St
Tacoma, WA 98406-6625
Phone (303) 601-0241
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
| License | State | Type | Specialty |
|---|---|---|---|
| CG60739906 | WA | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Comprehensive Mental Health Center of Tacoma-Pierce County | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Tacoma, WA
- NPI 1952597056
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1488326400000",
"number": "1306386958",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2109 N ALDER ST",
"city": "TACOMA",
"state": "WA",
"postal_code": "984066625",
"telephone_number": "303-601-0241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "610 YAKIMA AVE",
"city": "TACOMA",
"state": "WA",
"postal_code": "984054851",
"telephone_number": "253-396-5246"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSBOTHAM",
"first_name": "REILLY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-03-01",
"last_updated": "2017-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WA",
"license": "CG60739906",
"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 Mar 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.