Individual provider Active NPI

Garyn Wrede

  • Peer Specialist
  • Seattle, WA
National Provider Identifier
1679302129
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
CG606012567 Issued in WA
Practice address
1600 S Lane St
Seattle, WA 98144-2810
Phone
(206) 682-2371
NPI assigned
Jul 31, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X CG606012567 WA Primary

Addresses

Primary practice location

1600 S Lane St
Seattle, WA 98144-2810

Mailing address

1600 S Lane St
Seattle, WA 98144-2810
Phone (206) 566-1060

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
CG606012567WAMDPeer Specialist

NPI Registry JSON

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

{
    "created_epoch": "1722384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1679302129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 S LANE ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981442810",
            "telephone_number": "206-566-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 S LANE ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981442810",
            "telephone_number": "206-682-2371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WREDE",
        "first_name": "GARYN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-31",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "WA",
            "license": "CG606012567",
            "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 Jul 31, 2024; 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.