Individual provider Active NPI

Ousman Jerreh Cham

  • Behavior Technician
  • Mukilteo, WA
National Provider Identifier
1649700097
Registry record updated Jun 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
10710 Mukilteo Speedway
Mukilteo, WA 98275-5021
Phone
(425) 349-8888
NPI assigned
Jun 18, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

10710 Mukilteo Speedway
Mukilteo, WA 98275-5021

Mailing address

3406 Larch Way
Lynnwood, WA 98036-6867
Phone (425) 773-2049

Other identifiers 1

IdentifierTypeStateIssuer
106500000XMedicaidWA

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

NPI Registry JSON

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

{
    "created_epoch": "1497744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497744000000",
    "number": "1649700097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3406 LARCH WAY",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980366867",
            "telephone_number": "425-773-2049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10710 MUKILTEO SPEEDWAY",
            "city": "MUKILTEO",
            "state": "WA",
            "postal_code": "982755021",
            "telephone_number": "425-349-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAM",
        "first_name": "OUSMAN",
        "middle_name": "JERREH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-18",
        "last_updated": "2017-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106500000X",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mukilteo, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2017; 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.