Individual provider Active NPI

Mary Arlene Keefer Osborne, SUPD

  • Addiction (Substance Use Disorder) Counselor
  • Wenatchee, WA
National Provider Identifier
1326474784
Registry record updated Jan 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CO 60392444 Issued in WA
Practice address
819 N Miller St Ste 1
Wenatchee, WA 98801-6604
Phone
(509) 664-4592
NPI assigned
Sep 17, 2013
Last updated
Jan 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2023

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 CO 60392444 WA Primary

Addresses

Primary practice location

819 N Miller St Ste 1
Wenatchee, WA 98801-6604

Mailing address

600 Orondo Ave Ste 1
Wenatchee, WA 98801-2800
Phone (509) 662-6000

Other practice location 1

1601 E Fourth Plain Blvd Bldg 17
Vancouver, WA 98661-3717
Phone (360) 397-8246

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
CO 60392444WAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Valley Community Health Addiction (Substance Use Disorder) Past Accepting new patients
Columbia Valley Community Health Addiction (Substance Use Disorder) PastSince Jan 15, 2023 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1379376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1326474784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 ORONDO AVE STE 1",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012800",
            "telephone_number": "509-662-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 N MILLER ST STE 1",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988016604",
            "telephone_number": "509-664-4592"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 E Fourth Plain Blvd Bldg 17",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986613717",
            "country_code": "US",
            "telephone_number": "360-397-8246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEEFER OSBORNE",
        "first_name": "MARY",
        "middle_name": "ARLENE",
        "name_prefix": "Ms.",
        "credential": "SUPD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-17",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CO 60392444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wenatchee, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2023; 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.