Deeanna Personius, LW61596199

Primary specialty

Social WorkerTaxonomy code 104100000X

License

LW61596199 Issued in WA

Practice address

15455 65TH Ave S
Tukwila, WA 98188-2534

Phone

(206) 721-5170

Fax

(360) 575-1950

NPI assigned

Sep 14, 2021

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

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cowlitz Indian TribeGroup PAC ID 8820030133, 26 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Cowlitz Indian Tribe

  • Clinic/Center
  • Longview, WA
  • NPI 1740562909

  TX

  Medicare reassignment Care Compare group NPD
• Cowlitz Indian Tribe

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Vancouver, WA
  • NPI 1538412630
  NPD
• Cowlitz Indian Tribe

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Vancouver, WA
  • NPI 1164649679
  NPD (past)
• Cowlitz Indian Tribe

  • Public Health & General Preventive Medicine Physician
  • Longview, WA
  • NPI 1619194123
  NPD (past)
• Cowlitz Indian Tribe

  • General Practice Physician
  • Longview, WA
  • NPI 1851328447
  NPD (past)
• Cowlitz Indian Tribe

  • Public Health & General Preventive Medicine Physician
  • Vancouver, WA
  • NPI 1972962165
  NPD (past)

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

{
    "created_epoch": "1631577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1720758535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2429",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986328486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15455 65TH AVE S",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981882534",
            "telephone_number": "206-721-5170",
            "fax_number": "360-575-1950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSONIUS",
        "first_name": "DEEANNA",
        "credential": "LW61596199",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-14",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WA",
            "license": "LW61596199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Corbett Perkins, LMHC
• Nate Perrault
• Michele Marie Perrin, SUDP, RAAC
• Donielle Perrine
• Grace Persall
• Amarri Peterson
• Brooke Peterson
• Michael R Peterson, M.D.
• Dale Lawrence Petrich, DDS
• Matija Petrovcic

• Social Worker in Tukwila, WA
• Providers in Tukwila, WA by specialty
• Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.