NPIMap

Organization Active NPI

Cascadia Addiction-Bountiful Life Treatment Center PLLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Bremerton, WA
National Provider Identifier
1932286101
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
CP00002242 Issued in WA
Legal business name
CASCADIA ADDICTION-BOUNTIFUL LIFE TREATMENT CENTER PLLC
Practice address
2817 Wheaton Way Ste 205
Bremerton, WA 98310-3440
Phone
(360) 373-0155
Fax
(360) 373-0258
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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

Authorized official

Name
Mr. Steven Paul Tikunoff Jr., SUDPNPI 1316544174
Title
Administrator
Phone
(360) 373-0155

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YA0400X CP00002242 WA
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X CP00002242 WA Primary

Addresses

Primary practice location

2817 Wheaton Way Ste 205
Bremerton, WA 98310-3440

Mailing address

2817 Wheaton Way Ste 205
Bremerton, WA 98310-3440
Phone (360) 373-0155

Other identifiers 1

IdentifierTypeStateIssuer
1995612MedicaidWA

Other names 1

  • Bountiful Life Addiction Treatment Doing business as

National Provider Directory

National Provider Directory

Locations

2817 Wheaton Way
Ste 205
Bremerton, WA 98310
Phone (360) 373-0155

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757376000000",
    "number": "1932286101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 WHEATON WAY STE 205",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983103440",
            "telephone_number": "360-373-0155",
            "fax_number": "360-373-0258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 WHEATON WAY STE 205",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983103440",
            "telephone_number": "360-373-0155",
            "fax_number": "360-373-0258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASCADIA ADDICTION-BOUNTIFUL LIFE TREATMENT CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A",
        "authorized_official_last_name": "TIKUNOFF",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "360-373-0155",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "SUDP"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP00002242",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "WA",
            "license": "CP00002242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1995612",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bountiful Life Addiction Treatment",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bremerton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2025; 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.