Active NPI
Jonathan Douglas
- Counselor
- Yakima, WA
National Provider Identifier
1336381615
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- CG60173532
- Practice address
- 402 S 4TH Ave
Yakima, WA 98902-3546 - Phone
- (509) 575-4084
- NPI assigned
- Apr 1, 2009
- Last updated
- Mar 17, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 | CG60173532 | WA | Primary |
Addresses
Primary practice location
402 S 4TH Ave
Yakima, WA 98902-3546
Mailing address
PO Box 959
Yakima, WA 98907-0959
Phone (509) 575-4018
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 |
|---|---|---|---|
| CG60173532 | WA | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ruston Therapy PLLC | 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, 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": "1238544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1300320000000",
"number": "1336381615",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 959",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989070959",
"telephone_number": "509-575-4018"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "402 S 4TH AVE",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989023546",
"telephone_number": "509-575-4084"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUGLAS",
"first_name": "JONATHAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-04-01",
"last_updated": "2011-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WA",
"license": "CG60173532",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yakima, WA
- Roland Evan Dougherty, PH.D.
- Douglas & Topper PS (Yakima Oral Surgery Associates)
- Douglas Topper Wilson Miller and Bosshardt PS (Yakima Oral Surgery Associates)
- Chad Richard Douglas, D.O.
- David L Douglas
- Lindsey R Douglas III, DMD
- Tyler Shane Douglas, CP61119971
- Wena Lynn Dove, LMP
- Lucy Johanna Dow, MSN, RN, APRN, FNP-C
- Dr Mileski DDS II PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.