Individual provider Active NPI

Yaxu Zhang

  • Addiction (Substance Use Disorder) Counselor
  • Seattle, WA
National Provider Identifier
1952961781
Registry record updated Mar 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CP61106980 Issued in WA
Practice address
3639 Martin Luther King Jr Way S
Seattle, WA 98144-6847
Phone
(206) 785-9482
NPI assigned
Jun 14, 2019
Last updated
Mar 8, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CP61106980 WA Primary
Social Worker 104100000X LW61383008 WA

Addresses

Primary practice location

3639 Martin Luther King Jr Way S
Seattle, WA 98144-6847

Mailing address

3639 Martin Luther King Jr Way S
Seattle, WA 98144-6847
Phone (206) 785-9482

Other practice location 1

720 8th Ave S
Seattle, WA 98104-3032
Phone (206) 788-3666

Other identifiers 1

IdentifierTypeStateIssuer
2138265MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20230322000285 WA Practitioner - Clinical Social Worker 4284008855 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CP61106980WAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
International Community Health Services Current Accepting new patients
International Community Health Services CurrentSince Mar 3, 2023 Accepting new patients
International Community Health Services CurrentSince Mar 3, 2023 Accepting new patients

Locations

3639 Mlk Jr Way S
Seattle, WA 98144
Phone (206) 695-7637

3815 S Othello St
Fl 2
Seattle, WA 98118
Phone (206) 788-3500

720 8th Ave S
Seattle, WA 98104
Phone (206) 788-3757

16549 Aurora Ave N
Shoreline, WA 98133
Phone (206) 533-2600

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1560470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1952961781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3639 MARTIN LUTHER KING JR WAY S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981446847",
            "telephone_number": "206-785-9482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3639 MARTIN LUTHER KING JR WAY S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981446847",
            "telephone_number": "206-785-9482"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "720 8th Ave S",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981043032",
            "country_code": "US",
            "telephone_number": "206-788-3666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZHANG",
        "first_name": "YAXU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-14",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP61106980",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WA",
            "license": "LW61383008",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2138265",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.