Active NPI
Dilma Lizet Demartino
- Case Manager/Care Coordinator
- Shelton, WA
National Provider Identifier
1942869938
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 235 S 3Rd St
Shelton, WA 98584-2255 - Phone
- (360) 868-2697
- Fax
- (360) 358-8524
- NPI assigned
- Jun 12, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CO60871094 | WA | |
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
235 S 3Rd St
Shelton, WA 98584-2255
Mailing address
235 S 3Rd St
Shelton, WA 98584-2255
Phone (360) 868-2697
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
| License | State | Type | Specialty |
|---|---|---|---|
| CO60871094 | WA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567036800000",
"number": "1942869938",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "235 S 3RD ST",
"city": "SHELTON",
"state": "WA",
"postal_code": "985842255",
"telephone_number": "360-868-2697",
"fax_number": "360-358-8524"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "235 S 3RD ST",
"city": "SHELTON",
"state": "WA",
"postal_code": "985842255",
"telephone_number": "360-868-2697",
"fax_number": "360-358-8524"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMARTINO",
"first_name": "DILMA",
"middle_name": "LIZET",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-12",
"last_updated": "2019-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WA",
"license": "CO60871094",
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shelton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.