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1699079301 NPI number — DARREL R STARTIN JR. BA, CDP

NPI Number: 1699079301
Health Care Provider/Practitioner: DARREL R STARTIN JR. BA, CDP

Information about “1699079301” NPI (DARREL R STARTIN JR. BA, CDP) exists in 1699079301 in HTML format HTML  |  1699079301 in plain Text format TXT  |  1699079301 in PDF (Portable Document Format) PDF  |  1699079301 in an XML format XML  formats.

NPI Number : 1699079301 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1699079301",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "STARTIN",
    "FirstName": "DARREL",
    "MiddleName": "R",
    "NamePrefix": "MR.",
    "NameSuffix": "JR.",
    "Credential": "BA, CDP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "9415 E TRENT AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SPOKANE VALLEY",
    "MailingAddressStateName": "WA",
    "MailingAddressPostalCode": "99206-4218",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "509-926-3361",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "9415 E TRENT AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SPOKANE VALLEY",
    "PracticeLocationAddressStateName": "WA",
    "PracticeLocationAddressPostalCode": "99206-4218",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "509-926-3361",
    "PracticeLocationAddressFaxNumber": "509-927-8420",
    "EnumerationDate": "01/10/2011",
    "LastUpdateDate": "01/10/2011",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "101YA0400X",
        "TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
        "LicenseNumber": "CP 00004556",
        "LicenseNumberStateCode": "WA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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