Breanne Nicole Smith, CP60896258

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CP60896258 Issued in WA

Practice address

PO Box 217
Selah, WA 98942-0217

Phone

(509) 457-0990

NPI assigned

Mar 29, 2017

Last updated

Jun 4, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sundown M Ranch

  • Family Medicine Physician
  • Yakima, WA
  • NPI 1285223305
  NPD
• Sundown M Ranch

  • Substance Abuse Rehabilitation Facility
  • Yakima, WA
  • NPI 1154474104
  NPD (past)

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

{
    "created_epoch": "1490745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1417489501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "927 N 4TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989021409",
            "telephone_number": "509-895-1584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 217",
            "city": "SELAH",
            "state": "WA",
            "postal_code": "989420217",
            "telephone_number": "509-457-0990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BREANNE",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "CP60896258",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-29",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP60896258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Selah School District
• Selah Vision Source, PLLC (Selah Vision Clinic)
• Selah's Smiles Dental, LLC
• Diana Smigaj, M.D.
• Avena M Smith
• Manuela G Soria
• Shereen K Stocker, ARNP
• Sunnyside Community Hospital Association (Astria Health Center)
• The Markets LLC (Selah SaveOn Foods #845 Pharmacy)
• Therapeutic Associates Inc (TAI - Selah)

• Addiction (Substance Use Disorder) Counselor in Selah, WA
• Providers in Selah, 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 Jun 4, 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.