Active NPI
Shelly Marie Thornton, CM60444430
- Counselor
- Everett, WA
National Provider Identifier
1689033425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- CM60444430
- Practice address
- 811 Madison St
Everett, WA 98203-4543 - Phone
- (425) 212-4200
- Fax
- (425) 212-4201
- NPI assigned
- Feb 22, 2016
- Last updated
- Mar 1, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | CM60444430 | WA | Primary |
Addresses
Primary practice location
811 Madison St
Everett, WA 98203-4543
Mailing address
PO Box 2569
Everett, WA 98213-4543
Phone (425) 212-4200
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
| License | State | Type | Specialty |
|---|---|---|---|
| CM60444430 | WA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1456099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456790400000",
"number": "1689033425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2569",
"city": "EVERETT",
"state": "WA",
"postal_code": "982134543",
"telephone_number": "425-212-4200",
"fax_number": "425-212-4201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "811 MADISON ST",
"city": "EVERETT",
"state": "WA",
"postal_code": "982034543",
"telephone_number": "425-212-4200",
"fax_number": "425-212-4201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THORNTON",
"first_name": "SHELLY",
"middle_name": "MARIE",
"credential": "CM60444430",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-02-22",
"last_updated": "2016-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WA",
"license": "CM60444430",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.