Constance NMN Washington

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

60599340 Issued in WA

Practice address

410 E 61St St
Tacoma, WA 98404-1929

Phone

(253) 376-0653

Fax

(206) 363-9639

NPI assigned

Feb 23, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• None NMN Duncan, Jackson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1614038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1336733005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 E 61ST ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984041929",
            "telephone_number": "253-376-0653",
            "fax_number": "206-363-9639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 E 61ST ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984041929",
            "telephone_number": "253-376-0653",
            "fax_number": "206-363-9639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASHINGTON",
        "first_name": "CONSTANCE",
        "middle_name": "NMN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-23",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WA",
            "license": "60599340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NONE",
            "last_name": "DUNCAN, JACKSON",
            "middle_name": "NMN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Professional Counselor in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Professional Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2021; 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.