MR. JASON RAYDR-SCOTT GOMEZ (NPI# 1336603026) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336603026 |
| Entity Type | Individual |
| Full Name | MR. JASON RAYDR-SCOTT GOMEZ |
| Credential | CDPT |
| Practice Address |
31912 Little Boston Rd Ne Kingston WA 98346-9700 |
| Practice Telephone | 3602976329 |
| Mailing Telephone | 3602976329 |
| Enumeration Date | 2019-01-26 |
| Last Update Date | 2019-01-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
60777486 | WA | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4060 Wheaton Way Ste F, Bremerton, WA 983103500 | 3608769430 |
| Street Address |
31912 LITTLE BOSTON RD NE |
| City | KINGSTON |
| State | WA |
| Zip Code | 98346-9700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992973754 | Courtney Elizabeth Oliver | Counselor | 31912 Little Boston Rd Ne, Port Gamble Sklallam Tribe, Kingston, WA 98346-9700 | 2008-02-14 |
| 1942734884 | Adam Jackson | Counselor | 31912 Little Boston Rd Ne, Kingston, WA 98346-9700 | 2017-04-18 |
| 1891109757 | Susan Krall | Counselor | 31912 Little Boston Rd Ne, Kingston, WA 98346-9700 | 2014-06-18 |
| 1528348182 | Jamie Ruth Barringer | Counselor | 31912 Little Boston Rd Ne, Kingston, WA 98346-9700 | 2011-08-26 |
| 1154614808 | Heidi C. Clark | Case Manager/Care Coordinator | 31912 Little Boston Rd Ne, Kingston, WA 98346-9700 | 2011-05-26 |
| 1447574439 | Amy Elizabeth Gordon | Clinic/Center | 31912 Little Boston Rd Ne, Kingston, WA 98346-9700 | 2010-03-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831725688 | Sierra Joye Lari | Massage Therapist | 8202 Ne Highway 104, Suite 105, Kingston, WA 98346 | 2020-03-12 |
| 1235641705 | Reba Lee Harris | Counselor | 7550 Little Boston Road N.e, Kingston, WA 98346 | 2017-10-24 |
| 1134592421 | Honeycomb Medical Services, A Med Corp | Physician Assistant | 700 Alamo Pintado Road, Solvang, CA 98346 | 2015-11-09 |
| 1588000764 | Donald G Hill | Contractor | 26325 Ne Illinois Ave, B 105, Kingston, WA 98346 | 2013-05-15 |
| 1104161900 | Marcus Dean Atkinson | Massage Therapist | 8202 Ne Hwy 104, Ste 105, Kingston, WA 98346 | 2012-12-05 |
| 1245580687 | Samantha Christine Kottke | Massage Therapist | 25960 Ohio Ave Suite 206, Kingston, WA 98346 | 2012-09-13 |
| 1265713390 | Karen Dale Friend | Pharmacist | 8196 State Highway 104, Kingston, WA 98346 | 2011-09-02 |
| 1750526323 | Megan Elizabeth Pratt | Mechanotherapist | 25925 Washington Blvd., Kingston, WA 98346 | 2008-12-10 |
| 1073787412 | Cindy Pamela Haines | Massage Therapist | 25925 Washington Boulevard Ne, Kingston, WA 98346 | 2008-04-16 |
| 1417163031 | Dian Aletha Poyssick | Pharmacist | 8196 State Route 104, Kingston, WA 98346 | 2007-05-14 |
| Find all providers in zip 98346 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386267490 | A Prodigal's Path 2 Recovery, Inc. | Counselor | 107 Paint Rock Ferry Rd, Kingston, TN 37763-2921 | 2020-05-22 |
| 1235641705 | Reba Lee Harris | Counselor | 7550 Little Boston Road N.e, Kingston, WA 98346 | 2017-10-24 |
| 1386989838 | Shawna Fanning | Counselor | 161 Summer St Ste 7, Kingston, MA 02364-1275 | 2012-12-10 |
| 1639481633 | Karen Holcomb | Counselor | 400 3rd Ave Ste 308, Kingston, PA 18704-5816 | 2010-07-07 |
| 1992973754 | Courtney Elizabeth Oliver | Counselor | 31912 Little Boston Rd Ne, Port Gamble Sklallam Tribe, Kingston, WA 98346-9700 | 2008-02-14 |
| 1831297670 | James M Sullivan | Counselor | 28 Ocean Hill Dr, Kingston, MA 02334 | 2006-09-20 |
| 1831718501 | Constance Marie Carr | Counselor | 144 Pine St Ste 140, Kingston, NY 12401-4946 | 2020-04-13 |
| 1366927071 | Rebecca Vanduzer | Counselor | 3 Family Practice Dr, Kingston, NY 12401-6449 | 2018-09-27 |
| 1942734884 | Adam Jackson | Counselor | 31912 Little Boston Rd Ne, Kingston, WA 98346-9700 | 2017-04-18 |
| 1275981573 | Wyoming Valley Alcohol and Drug Services Inc | Counselor | 480 Pierce St, 316-317, Kingston, PA 18704-5512 | 2016-05-26 |
| Find all providers in KINGSTON | ||||
Please comment or provide details below to improve the information on MR. JASON RAYDR-SCOTT GOMEZ.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.