Active NPI
Gavin McCoy Mast
- Counselor
- Olympia, WA
National Provider Identifier
1467927418
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 3857 Martin Way E
Olympia, WA 98506-5268 - Phone
- (360) 704-7170
- NPI assigned
- Oct 5, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-18-66697 | CA | |
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
3857 Martin Way E
Olympia, WA 98506-5268
Mailing address
16782 Von Karman Ave Ste 11
Irvine, CA 92606-2417
Phone (855) 223-7123
Other practice location 1
3680 S Cedar St Ste A
Tacoma, WA 98409-5728
Phone (855) 223-7123
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-18-66697 | CA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1538697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660780800000",
"number": "1467927418",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16782 VON KARMAN AVE STE 11",
"city": "IRVINE",
"state": "CA",
"postal_code": "926062417",
"telephone_number": "855-223-7123"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3857 MARTIN WAY E",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985065268",
"telephone_number": "360-704-7170"
}
],
"practiceLocations": [
{
"address_1": "3680 S Cedar St Ste A",
"address_purpose": "LOCATION",
"city": "Tacoma",
"state": "WA",
"postal_code": "984095728",
"country_code": "US",
"telephone_number": "855-223-7123",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MAST",
"first_name": "GAVIN",
"middle_name": "MCCOY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-10-05",
"last_updated": "2022-08-18",
"certification_date": "2022-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CA",
"license": "RBT-18-66697",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Olympia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 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.