Richard Nelson, CDP

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CP60675388 Issued in WA

Practice address

9930 Evergreen Way
Z150
Everett, WA 98204-3883

Phone

(425) 347-5121

Fax

(425) 353-6425

NPI assigned

Nov 23, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1479859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479859200000",
    "number": "1972046969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9930 EVERGREEN WAY",
            "address_2": "Z150",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982043883",
            "telephone_number": "425-347-5121",
            "fax_number": "425-353-6425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9930 EVERGREEN WAY",
            "address_2": "Z150",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982043883",
            "telephone_number": "425-347-5121",
            "fax_number": "425-353-6425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "RICHARD",
        "credential": "CDP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-11-23",
        "last_updated": "2016-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP60675388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jill Kristine Nelson, PA-C
• Lauralie Ann Nelson, COUNSELOR
• Maja Sophia Nelson, CRNA
• Matthew Nelson, D.C.
• Natalie Nelson
• Sara Nelson, MD
• Vanessa Nelson
• Nataly I. Nemirovsky, MHP
• Michael Nepomuceno
• Tawnya Rene Nettles, LMP

• Addiction (Substance Use Disorder) Counselor in Everett, WA
• Providers in Everett, WA by specialty
• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2016; 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.