Active NPI
Donald R. Tjossem, MS, MAC, SAP, CDP
- Counselor
- Lakebay, WA
National Provider Identifier
1649483009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- RC00039575
- Practice address
- 8903 Key Peninsula Hwy N
Lakebay, WA 98349-9326 - Phone
- (253) 884-4860
- Fax
- (253) 830-0174
- NPI assigned
- May 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | RC00039575 | WA | Primary |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CPOOOO4019 | WA |
Addresses
Primary practice location
8903 Key Peninsula Hwy N
Lakebay, WA 98349-9326
Mailing address
8903 Key Peninsula Hwy N
Lakebay, WA 98349-9326
Phone (253) 884-4860
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RC00039575 | WA | MD | Counselor |
| CPOOOO4019 | WA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1649483009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8903 KEY PENINSULA HWY N",
"city": "LAKEBAY",
"state": "WA",
"postal_code": "983499326",
"telephone_number": "253-884-4860",
"fax_number": "253-830-0174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8903 KEY PENINSULA HWY N",
"city": "LAKEBAY",
"state": "WA",
"postal_code": "983499326",
"telephone_number": "253-884-4860",
"fax_number": "253-830-0174"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TJOSSEM",
"first_name": "DONALD",
"middle_name": "R.",
"credential": "MS, MAC, SAP, CDP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-08",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WA",
"license": "RC00039575",
"primary": true
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WA",
"license": "CPOOOO4019",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakebay, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.