Individual provider Active NPI

Charles Quinn, CDP

  • Addiction (Substance Use Disorder) Counselor
  • Seattle, WA
National Provider Identifier
1578034971
Registry record updated Dec 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CP60739624 Issued in WA
Practice address
2815 Eastlake Ave E Ste 100
Seattle, WA 98102-3086
Phone
(206) 707-7582
Fax
(206) 341-9917
NPI assigned
Dec 10, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CP60739624 WA Primary

Addresses

Primary practice location

2815 Eastlake Ave E Ste 100
Seattle, WA 98102-3086

Mailing address

2815 Eastlake Ave E Ste 100
Seattle, WA 98102-3086
Phone (206) 707-7582

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

LicenseStateTypeSpecialty
CP60739624WAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1544400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544400000000",
    "number": "1578034971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2815 EASTLAKE AVE E STE 100",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981023086",
            "telephone_number": "206-707-7582",
            "fax_number": "206-341-9917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2815 EASTLAKE AVE E STE 100",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981023086",
            "telephone_number": "206-707-7582",
            "fax_number": "206-341-9917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINN",
        "first_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "CDP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-10",
        "last_updated": "2018-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP60739624",
            "primary": true
        }
    ],
    "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 Dec 10, 2018; 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.