Individual provider Active NPI

Dawn Marie Lee, CDP

  • Addiction (Substance Use Disorder) Counselor
  • Laconner, WA
National Provider Identifier
1922239607
Registry record updated Jul 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CP 00004174 Issued in WA
Practice address
17337 Reservation Road
Laconner, WA 98257-8802
Phone
(360) 466-7273
NPI assigned
Jul 29, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CP 00004174 WA Primary

Addresses

Primary practice location

17337 Reservation Road
Laconner, WA 98257-8802

Mailing address

4914 Wildlife Acres LN
Sedro Woolley, WA 98284-7828
Phone (360) 391-2988

Other identifiers 1

IdentifierTypeStateIssuer
1995216MedicaidWA

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

LicenseStateTypeSpecialty
CP 00004174WAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1248825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279497600000",
    "number": "1922239607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4914 WILDLIFE ACRES LN",
            "city": "SEDRO WOOLLEY",
            "state": "WA",
            "postal_code": "982847828",
            "telephone_number": "360-391-2988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17337 RESERVATION ROAD",
            "city": "LACONNER",
            "state": "WA",
            "postal_code": "982578802",
            "telephone_number": "360-466-7273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "DAWN",
        "middle_name": "MARIE",
        "credential": "CDP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-29",
        "last_updated": "2010-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP 00004174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1995216",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laconner, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2010; 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.