Angela Elliott, CP61279999

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CP61279999 Issued in WA

Practice address

6700 Martin Way E
Olympia, WA 98516-6502

Phone

(360) 413-6910

Fax

(360) 413-9026

NPI assigned

Aug 30, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Evergreen Treatment Services Unit 5

  • Methadone Clinic
  • Olympia, WA
  • NPI 1770638983
  NPD (past)

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

{
    "created_epoch": "1567123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1659929719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6700 MARTIN WAY E",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985166502",
            "telephone_number": "360-413-6910",
            "fax_number": "360-413-9026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6700 MARTIN WAY E",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985166502",
            "telephone_number": "360-413-6910",
            "fax_number": "360-413-9026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "ANGELA",
        "credential": "CP61279999",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-30",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP61279999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David R Elkins, PA
• Lauren Elle, LMP
• Jon Benjamin Eller
• Israel Ellerbrock, PTA
• Robin Grace Ellingson-Miller, ARNP
• Laura K Elliott, LMP
• Olivia Traver Ellis-Jenko, OTR/L
• Amber Ellis, L.M.P
• Elizabeth Ellis
• Evelyn Le Ellis, ND

• Addiction (Substance Use Disorder) Counselor in Olympia, WA
• Providers in Olympia, 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 May 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.