Individual provider Active NPI

Bashiir Abdulmumin

  • Addiction (Substance Use Disorder) Counselor
  • Bellevue, WA
National Provider Identifier
1417219478
Registry record updated Mar 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CP60238968 Issued in WA
Practice address
14270 NE 21St St # 98007
Bellevue, WA 98007-3720
Phone
(425) 653-5000
Fax
(425) 653-5010
NPI assigned
Jun 14, 2012
Last updated
Mar 12, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CP60238968 WA Primary

Addresses

Primary practice location

14270 NE 21St St # 98007
Bellevue, WA 98007-3720

Mailing address

6400 Southcenter Blvd
Tukwila, WA 98188-2547
Phone (206) 901-2000

Other practice location 1

9930 Evergreen Way Bldg 2154
Everett, WA 98204-3883
Phone (425) 263-3006

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1339632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520812800000",
    "number": "1417219478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 SOUTHCENTER BLVD",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981882547",
            "telephone_number": "206-901-2000",
            "fax_number": "206-901-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14270 NE 21ST ST # 98007",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980073720",
            "telephone_number": "425-653-5000",
            "fax_number": "425-653-5010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9930 Evergreen Way Bldg 2154",
            "address_purpose": "LOCATION",
            "city": "Everett",
            "state": "WA",
            "postal_code": "982043883",
            "country_code": "US",
            "telephone_number": "425-263-3006",
            "fax_number": "425-263-3007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABDULMUMIN",
        "first_name": "BASHIIR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-14",
        "last_updated": "2018-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP60238968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2018; 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.