Jesse F Bowen

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

61163896 Issued in WA

Practice address

1126 S Gold St
Centralia, WA 98531-3768

Phone

(360) 807-4929

Fax

(360) 807-4160

NPI assigned

Mar 15, 2021

Last updated

Aug 13, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Core Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Longview, WA
  • NPI 1639693781
  NPD
• Community Integrated Health Services, LLC

  • Community/Behavioral Health Agency
  • Centralia, WA
  • NPI 1942840160

  Peer Specialist

  NPD (past)

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

{
    "created_epoch": "1615766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628812800000",
    "number": "1831774405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2394",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986328455",
            "telephone_number": "360-200-5419",
            "fax_number": "360-200-6736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1126 S GOLD ST",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985313768",
            "telephone_number": "360-807-4929",
            "fax_number": "360-807-4160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWEN",
        "first_name": "JESSE",
        "middle_name": "F",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-15",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "WA",
            "license": "61163896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Andreyevich Bobrovnikov, CRNA
• Jazmin A Bolduc, OTR/L
• Patricia A Bond, MA
• Malsy Borgella
• Ann Louise Born, LMHC
• Darwin Bowser, MSPT, GCS
• Rebekah Boyd
• Katherine Brandner, COTA/L
• Debbie Brant
• Breath of Life Incorporated

• Peer Specialist in Centralia, WA
• Providers in Centralia, WA by specialty
• Peer Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.

Verify at the official NPI Registry.