Hailey Marae Rowe, SUDPT | NPI 1306495437

Key facts

NPI: 1306495437
Entity type: Individual (NPI type 1)
Primary specialty: Addiction (Substance Use Disorder) Counselor 101YA0400X
License: CO60986309 (WA)
Practice address: 702 Franklin Ave
Sunnyside, WA 98944
Phone: (509) 837-7700
NPI assigned: Sep 11, 2019
Sex: Female
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
CO60986309	WA	MD	Addiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Addiction (Substance Use Disorder) Counselor	101YA0400X	CO60986309	WA	Yes

Addresses

Primary practice location

702 Franklin Ave
Sunnyside, WA 98944

Mailing address

702 Franklin Ave
Sunnyside, WA 98944
Phone (509) 837-7700

Other identifiers

Identifier	Type	State	Issuer
91-0755984	Medicaid	WA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 7, 2020.

{
    "created_epoch": "1568160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588809600000",
    "number": "1306495437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 FRANKLIN AVE",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "98944",
            "telephone_number": "509-837-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 FRANKLIN AVE",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "98944",
            "telephone_number": "509-837-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROWE",
        "first_name": "HAILEY",
        "middle_name": "MARAE",
        "credential": "SUDPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-11",
        "last_updated": "2020-05-07",
        "certification_date": "2020-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CO60986309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "91-0755984",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyside, WA

All providers in Sunnyside, WA · Addiction (Substance Use Disorder) Counselor in Washington

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 7, 2020. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.