Jackie Elaine Washbish, SUDP

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CP60708363 Issued in WA

Practice address

904 S 3Rd St
Mount Vernon, WA 98273-4324

Phone

(360) 856-6300

Fax

(564) 209-7048

NPI assigned

Apr 10, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Ms. Jackie Elaine Rasmussen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• United Northwest Recovery Center Inc.

  • Addiction (Substance Use Disorder) Counselor
  • Mt. Vernon, WA
  • NPI 1336303387
  NPD Authorized official
• Peninsula Counseling, LLC

  • Community/Behavioral Health Agency
  • Gig Harbor, WA
  • NPI 1972085835

  Addiction (Substance Use Disorder)

  NPD (past)
• United NW Recovery Center Inc.

  • Exclusive Provider Organization
  • Sedro Woolley, WA
  • NPI 1316118177
  NPD (past)

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

{
    "created_epoch": "1365552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1376986174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 S 3RD ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982734324",
            "telephone_number": "360-856-6300",
            "fax_number": "504-209-7048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 S 3RD ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982734324",
            "telephone_number": "360-856-6300",
            "fax_number": "564-209-7048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASHBISH",
        "first_name": "JACKIE",
        "middle_name": "ELAINE",
        "name_prefix": "Ms.",
        "credential": "SUDP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-10",
        "last_updated": "2024-02-20",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP60708363",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2265964",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACKIE",
            "last_name": "RASMUSSEN",
            "middle_name": "ELAINE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Junfeng Wang, M.D.
• Clive Philip Ware, ARNP
• Heather Warner
• Audrey Kay Warolin, ARNP
• Max Edward Warren, ARNP
• Kandice Lee Waters, ARNP
• Heather Marie Watson, NP
• Paige Maureen Watson, M.S.
• Michelle Watterson
• Golda Waugh, M.ED.

• Addiction (Substance Use Disorder) Counselor in Mount Vernon, WA
• Providers in Mount Vernon, WA by specialty
• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.