Active NPI
Michael G Marshall, CDP
- Addiction (Substance Use Disorder) Counselor
- Port Orchard, WA
National Provider Identifier
1700297199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 00001081
- Practice address
- 1014 Bay St
Suite 24
Port Orchard, WA 98366-5242 - Phone
- (360) 602-0022
- Fax
- (360) 335-6432
- NPI assigned
- May 19, 2014
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 00001081 | WA | Primary |
Addresses
Primary practice location
1014 Bay St
Suite 24
Port Orchard, WA 98366-5242
Mailing address
1014 Bay St
Suite 24
Port Orchard, WA 98366-5242
Phone (360) 602-0022
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 |
|---|---|---|---|
| 00001081 | WA | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healthy Whole Solutions | Addiction (Substance Use Disorder) | Past | Accepting new patients |
Interoperability endpoints
- scott.lin.p1@direct.pgsklallamtribe.nextgenshare.com
- michael.marshall.p1@direct.pgsklallamtribe.nextgenshare.com
Organizations & group practices 1
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.
-
- Addiction (Substance Use Disorder) Counselor
- Port Orchard, WA
- NPI 1073839957
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618185600000",
"number": "1700297199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1014 BAY ST",
"address_2": "SUITE 24",
"city": "PORT ORCHARD",
"state": "WA",
"postal_code": "983665242",
"telephone_number": "360-602-0022",
"fax_number": "360-335-6432"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1014 BAY ST",
"address_2": "SUITE 24",
"city": "PORT ORCHARD",
"state": "WA",
"postal_code": "983665242",
"telephone_number": "360-602-0022",
"fax_number": "360-335-6432"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARSHALL",
"first_name": "MICHAEL",
"middle_name": "G",
"credential": "CDP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-05-19",
"last_updated": "2021-04-12",
"certification_date": "2021-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WA",
"license": "00001081",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Orchard, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.