Active NPI
Yaxu Zhang
- Addiction (Substance Use Disorder) Counselor
- Seattle, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- CP61106980
- 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, 2023
- 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 | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2138265 | Medicaid | WA |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CP61106980 | WA | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| International Community Health Services | Current | Accepting new patients | |
| International Community Health Services | Current | Accepting new patients | |
| International Community Health Services | Current | 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.
-
- Federally Qualified Health Center (FQHC)
- Seattle, WA
- NPI 1376659151
-
dba ICHS at Sound Auburn
- Federally Qualified Health Center (FQHC)
- Auburn, WA
- NPI 1831910439
-
- Federally Qualified Health Center (FQHC)
- Seattle, WA
- NPI 1902983109
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.