NPIMap

Organization Active NPI

Island Center for Complementary Medicine Inc P S

  • Mental Health Counselor
  • Seattle, WA
National Provider Identifier
1437270675
Registry record updated Nov 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH00003885 Issued in WA
Legal business name
ISLAND CENTER FOR COMPLEMENTARY MEDICINE INC P S
Practice address
4649 Sunnyside Ave N
Suite 343
Seattle, WA 98103-6900
Phone
(206) 215-0534
Fax
(206) 524-6530
NPI assigned
Apr 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2011

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

Authorized official

Name
Ms. Deborah Rose Houseworth, L.AC.NPI 1194840009
Title
President
Phone
(206) 525-0750

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X LH00003885 WA
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X LH00003885 WA Primary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X AC00000208 WA

Addresses

Primary practice location

4649 Sunnyside Ave N
Suite 343
Seattle, WA 98103-6900

Mailing address

6826 28TH Ave NE
Seattle, WA 98115-7145
Phone (206) 525-0750

National Provider Directory

National Provider Directory
Tax ID family
Island Center for Complementary Medicine Inc P S5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4649 Sunnyside Ave N
Ste 343
Seattle, WA 98103
Phone (206) 215-0534

Practitioners & affiliated clinicians

Practitioners 2

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": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320278400000",
    "number": "1437270675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6826 28TH AVE NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981157145",
            "telephone_number": "206-525-0750",
            "fax_number": "206-524-6530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4649 SUNNYSIDE AVE N",
            "address_2": "SUITE 343",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981036900",
            "telephone_number": "206-215-0534",
            "fax_number": "206-524-6530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND CENTER FOR COMPLEMENTARY MEDICINE INC P S",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2011-11-03",
        "status": "A",
        "authorized_official_last_name": "HOUSEWORTH",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "ROSE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "206-525-0750",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "L.AC."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "LH00003885",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH00003885",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "WA",
            "license": "AC00000208",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2011; 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.