NPIMap

Organization Active NPI

Fountaingate Wellness PLLC

  • Addiction (Substance Use Disorder) Counselor
  • Marysville, WA
National Provider Identifier
1407501364
Registry record updated Feb 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
FOUNTAINGATE WELLNESS PLLC
Practice address
1106 Columbia Ave Ste 100
Marysville, WA 98270-4311
Phone
(360) 653-0374
NPI assigned
Feb 18, 2022
Last updated
Feb 18, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2022

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

Authorized official

Name
Scott D WykesNPI 1740325752
Title
Owner
Phone
(360) 653-0374

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YA0400X Primary

Addresses

Primary practice location

1106 Columbia Ave Ste 100
Marysville, WA 98270-4311

Mailing address

1106 Columbia Ave Ste 100
Marysville, WA 98270-4311

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL https://fountaingate.business.site/?utm_source=gmb&utm_medium=referral
Other URL https://fountaingate.business.site/?utm_source=gmb&utm_medium=referral

National Provider Directory

National Provider Directory

Locations

1106 Columbia Ave
Ste 100
Marysville, WA 98270
Phone (360) 653-0374

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1645142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645142400000",
    "number": "1407501364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 COLUMBIA AVE STE 100",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982704311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 COLUMBIA AVE STE 100",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982704311",
            "telephone_number": "360-653-0374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNTAINGATE WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-18",
        "last_updated": "2022-02-18",
        "certification_date": "2022-02-18",
        "status": "A",
        "authorized_official_last_name": "WYKES",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-653-0374"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://fountaingate.business.site/?utm_source=gmb&utm_medium=referral",
            "affiliation": "N",
            "address_1": "1106 Columbia Ave Ste 100",
            "city": "Marysville",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982704311",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://fountaingate.business.site/?utm_source=gmb&utm_medium=referral",
            "affiliation": "N",
            "address_1": "1106 Columbia Ave Ste 100",
            "city": "Marysville",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982704311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marysville, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2022; 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.