Perry Allen Landrum, SUDP, SUDPT

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

CDPT.CO.61106327 Issued in WA

Practice address

5001 112TH St E
Tacoma, WA 98446-5307

Phone

(253) 238-7217

NPI assigned

Jun 28, 2024

Sex

Male

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

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": "1719532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786320000000",
    "number": "1396580502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 112TH ST E",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984465307",
            "telephone_number": "253-238-7217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 112TH ST E",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984465307",
            "telephone_number": "253-238-7217"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2704 I St NE",
            "address_purpose": "LOCATION",
            "city": "Auburn",
            "state": "WA",
            "postal_code": "980022411",
            "country_code": "US",
            "telephone_number": "253-833-7444",
            "fax_number": "253-661-8631",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANDRUM",
        "first_name": "PERRY",
        "middle_name": "ALLEN",
        "credential": "SUDP, SUDPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-28",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CDP.CP.61590366",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WA",
            "license": "CDPT.CO.61106327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2291389",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathryn E Landau, PA-C
• Thomas Landers Jr., MA 60234020
• Johanna Landinez, M.D.
• Jennifer Lynne Landon, RN
• Mary Anne Elizabeth Landowski, RN00130116
• Anastasi Landskov, PTA
• Karen Ann Landwehr, M.C.
• Katherine Z Landy, MD
• Dathan J Lane, B.S.
• Hayley Lane

• Student in an Organized Health Care Education/Training Program in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Student in an Organized Health Care Education/Training Program in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2026; 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.