Mia Elizabeth Pridemore, SUDPT

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CO70011743 Issued in WA

Practice address

921 Harvey Rd NE Ste C
Auburn, WA 98002-4294

Phone

(253) 939-2211

Fax

(253) 939-2867

NPI assigned

Oct 5, 2026

Last updated

Oct 5, 2026By the provider in NPPES

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

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

{
    "created_epoch": "1791158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791158400000",
    "number": "1700780665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 HARVEY RD NE STE C",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980024294",
            "telephone_number": "253-939-2211",
            "fax_number": "253-939-2867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 HARVEY RD NE STE C",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980024294",
            "telephone_number": "253-939-2211",
            "fax_number": "253-939-2867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIDEMORE",
        "first_name": "MIA",
        "middle_name": "ELIZABETH",
        "credential": "SUDPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-10-05",
        "last_updated": "2026-10-05",
        "certification_date": "2026-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CO70011743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.