Pacific Medical Evaluations and Treatment Services, PLLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

GROUP PRACTICE - MAN Issued in WA

Legal business name

PACIFIC MEDICAL EVALUATIONS AND TREATMENT SERVICES, PLLC

Practice address

10634 E Riverside Dr Ste 130
Bothell, WA 98011-3758

Phone

(425) 806-5021

NPI assigned

Sep 28, 2007

Last updated

Apr 20, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rebecca Lyn Peterson

Title

Businss Manager

Phone

(425) 802-2861

Specialties & licenses 1

Addresses

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Puget Sound Psychiatric Center, PS

  dba PSPC

  • Psychiatry Physician
  • Bothell, WA
  • NPI 1114254729

  Member Of

  NPD member

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.

• Syed Jamal Mustafa, M.D.

  • Psychiatry Physician
  • Bothell, WA
  • NPI 1609883180
  NPD (past)

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

{
    "created_epoch": "1190937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1487841953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10634 E RIVERSIDE DR STE 130",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980113758",
            "telephone_number": "425-806-5021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10634 E RIVERSIDE DR STE 130",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980113758",
            "telephone_number": "425-806-5021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC MEDICAL EVALUATIONS AND TREATMENT SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-28",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "LYN",
        "authorized_official_title_or_position": "BUSINSS MANAGER",
        "authorized_official_telephone_number": "425-802-2861"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "GROUP PRACTICE - MAN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pacific Roots Mental Health
• Pacific Vascular Incorporated
• Pacific Vascular Incorporated
• Pacmed Clinics

• Mental Health Counselor in Bothell, WA
• Providers in Bothell, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.