Individual provider Active NPI

Nancy Ruth Gretzer-Smith

  • Counselor
  • Redmond, WA
National Provider Identifier
1356646269
Registry record updated Jan 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
CG60116084 Issued in WA
Practice address
11629 Avondale Rd NE
Avondale House
Redmond, WA 98052-2201
Phone
(206) 302-2200
Fax
(206) 302-2210
NPI assigned
Jan 24, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X CG60116084 WA Primary
Technician 374700000X CG60116084 WA

Addresses

Primary practice location

11629 Avondale Rd NE
Avondale House
Redmond, WA 98052-2201

Mailing address

1600 E Olive St
Sound Mental Health
Seattle, WA 98122-2735
Phone (206) 302-2200

Other names 1

  • Nancy R Smith Professional name

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
CG60116084WAMDTechnician

NPI Registry JSON

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

{
    "created_epoch": "1295827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295827200000",
    "number": "1356646269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 E OLIVE ST",
            "address_2": "SOUND MENTAL HEALTH",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981222735",
            "telephone_number": "206-302-2200",
            "fax_number": "206-302-2210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11629 AVONDALE RD NE",
            "address_2": "AVONDALE HOUSE",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980522201",
            "telephone_number": "206-302-2200",
            "fax_number": "206-302-2210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRETZER-SMITH",
        "first_name": "NANCY",
        "middle_name": "RUTH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-24",
        "last_updated": "2011-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "CG60116084",
            "primary": true
        },
        {
            "code": "374700000X",
            "taxonomy_group": "",
            "desc": "Technician",
            "state": "WA",
            "license": "CG60116084",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NANCY",
            "last_name": "SMITH",
            "middle_name": "R",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Redmond, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 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.

Verify at the official NPI Registry.