Individual provider Active NPI

Stacey Wiese

  • Counselor
  • Kirkland, WA
National Provider Identifier
1366260200
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
12009 100TH Ave NE Apt 5
Kirkland, WA 98034-3826
Phone
(208) 995-6924
NPI assigned
Sep 30, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

12009 100TH Ave NE Apt 5
Kirkland, WA 98034-3826

Mailing address

12009 100TH Ave NE Apt 5
Kirkland, WA 98034-3826
Phone (208) 995-6924

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

NPI Registry JSON

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

{
    "created_epoch": "1727654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1366260200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12009 100TH AVE NE APT 5",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343826",
            "telephone_number": "208-995-6924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12009 100TH AVE NE APT 5",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343826",
            "telephone_number": "208-995-6924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIESE",
        "first_name": "STACEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-30",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; 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.