Active NPI
Pedro Jimenez
- Addiction (Substance Use Disorder) Counselor
- Bellevue, WA
National Provider Identifier
1982882908
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- CP00006245
- Practice address
- 1412 140TH PL NE
Bellevue, WA 98007-3915 - Phone
- (425) 747-7892
- Fax
- (425) 747-8348
- NPI assigned
- Jan 31, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CP00006245 | WA | Primary |
Addresses
Primary practice location
1412 140TH PL NE
Bellevue, WA 98007-3915
Mailing address
1412 140TH PL NE
Bellevue, WA 98007-3915
Phone (425) 747-7892
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CP00006245 | 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": "1201737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339459200000",
"number": "1982882908",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1412 140TH PL NE",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980073915",
"telephone_number": "425-747-7892",
"fax_number": "425-747-8348"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1412 140TH PL NE",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980073915",
"telephone_number": "425-747-7892",
"fax_number": "425-747-8348"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JIMENEZ",
"first_name": "PEDRO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-01-31",
"last_updated": "2012-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WA",
"license": "CP00006245",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bellevue, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.