Andrea Ishem

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CP61294849 Issued in WA

Practice address

1412 SW 43Rd St Ste 140
Renton, WA 98057-4803

Phone

(206) 223-3644

NPI assigned

Apr 16, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1555372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1508429549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 AIRPORT WAY S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981341618",
            "telephone_number": "206-223-3644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 SW 43RD ST STE 140",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980574803",
            "telephone_number": "206-223-3644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISHEM",
        "first_name": "ANDREA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-16",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WA",
            "license": "60820643",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP61294849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kara Lynne Ireland
• Ashley Maria Irizarry, ND
• Lisa Marie Irons, LM P
• David Youngman Isenberg, DDS
• Sarah Elizabeth Isgur, MPT
• R Joseph Isner, MD
• Vanessa R Isom, SLP
• Sadia Mohamud Issa I
• Marianne Miller Iwamoto, ARNP, C-FNP
• Eugene Iwanyk, M.D.

• Addiction (Substance Use Disorder) Counselor in Renton, WA
• Providers in Renton, 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 Aug 31, 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.

Verify at the official NPI Registry.