Jeremy Wayne Grisham, BA, AAC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

4526 Federal Ave
Everett, WA 98203-2132

Phone

(206) 418-8808

NPI assigned

Nov 30, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Arts

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

{
    "created_epoch": "1512000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512000000000",
    "number": "1346754108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3405 NASSAU ST",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014142",
            "telephone_number": "206-418-8808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4526 FEDERAL AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982032132",
            "telephone_number": "206-418-8808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRISHAM",
        "first_name": "JEREMY",
        "middle_name": "WAYNE",
        "credential": "BA, AAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-30",
        "last_updated": "2017-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eileen Marie Grimes, PT, DPT
• Jasmine Soleil Grimes
• Ashley Gripe, DPT
• Jeannie Conway Grippin, M.A., CCC-SLP
• Casey Grisham
• Danielle M Grist
• Geri Lynne Groberg
• Anna Groeschel
• Sean Grorich, CRNA
• Penny M. Groshong, LMP

• Mental Health Counselor in Everett, WA
• Providers in Everett, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.

Verify at the official NPI Registry.