MR. JERRY DEAN BURTTS (NPI# 1356524219) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356524219 |
| Entity Type | Individual |
| Full Name | MR. JERRY DEAN BURTTS |
| Credential | GED |
| Practice Address |
514 S 13th St Tacoma WA 98402-1908 |
| Practice Telephone | 2533965000 |
| Practice Fax Number | 2533835548 |
| Mailing Telephone | 2533965000 |
| Mailing Fax Number | 2533835548 |
| Enumeration Date | 2007-12-13 |
| Last Update Date | 2018-11-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | RC00030610 | 05 |
| Street Address |
514 S 13TH ST |
| City | TACOMA |
| State | WA |
| Zip Code | 98402-1908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497978811 | Annette Marie Gagnon | Nurse Practitioner | 514 S 13th St, Tacoma, WA 98402-1908 | 2007-04-11 |
| 1184873044 | Martha Jane Miller | Counselor | 514 S 13th St, Tacoma, WA 98402-1908 | 2008-09-16 |
| 1679722532 | Marianela P. Bello | Counselor | 514 S 13th St, Tacoma, WA 98402-1908 | 2008-09-16 |
| 1104075969 | Kelly R. Crosson | Counselor | 514 S 13th St, Tacoma, WA 98402-1908 | 2008-09-16 |
| 1598914459 | Annette M. Simmons | Counselor | 514 S 13th St, Tacoma, WA 98402-1908 | 2008-09-16 |
| 1457512550 | Gretchen M Schutte | Counselor | 514 S 13th St, Tacoma, WA 98402-1908 | 2008-06-20 |
| 1144494246 | David Loyd Lambert | Social Worker | 514 S 13th St, Tacoma, WA 98402-1908 | 2008-04-18 |
| 1265606990 | Janet Elaine Rowlands | Licensed Practical Nurse | 514 S 13th St, Tacoma, WA 98402-1908 | 2008-04-14 |
| 1730366337 | Charles Franklin West | Counselor | 514 S 13th St, Tacoma, WA 98402-1908 | 2008-01-25 |
| 1417134479 | Margaret S Bruce | Counselor | 514 S 13th St, Tacoma, WA 98402-1908 | 2008-01-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548898638 | Cimberleigh Mclean | Social Worker | 2367 Tacoma Ave S Ofc 211, Tacoma, WA 98402 | 2020-04-01 |
| 1831735802 | Nickolas Justin Wise | Case Manager/Care Coordinator | 1159 Market St, Tacoma, WA 98402 | 2019-11-25 |
| 1841835436 | Michael Roy Bolden | Counselor | 1205 Tacoma Ave S., Suite 1205, Tacoma, WA 98402 | 2019-11-07 |
| 1073024980 | Megan Elizabeth Charron Mourfield | Denturist | 725 St Helens Ave S, Tacoma, WA 98402 | 2017-10-18 |
| 1104367937 | Janelle Santiago | Counselor | Mcdonald Smith Building 110, Uw Autism Center Tacoma, Tacoma, WA 98402 | 2017-03-13 |
| 1891167862 | Tanya Larson Therapy | Community/Behavioral Health | 1102 A. St., Suite 109, (suite 109), Tacoma, WA 98402 | 2015-10-29 |
| 1609242148 | Ashley Lorraine Dahlgren | Peer Specialist | 702 S 14th St., Tacoma, WA 98402 | 2015-08-19 |
| 1821416470 | Nicole Villarreal Mccormick | Acupuncturist | 711 A Ct #100, Tacoma, WA 98402 | 2014-04-01 |
| 1184055824 | Robyn Marie Callahan | Social Worker | 1102 A Street, Suite 202 B, Tacoma, WA 98402 | 2013-12-05 |
| 1679909410 | Kristin Sweet Fischer | Counselor | 708 Market St Unit 411, Tacoma, WA 98402 | 2013-09-25 |
| Find all providers in zip 98402 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558982058 | Edward Thomas Gollihugh | Peer Specialist | 721 Fawcett Ave Ste 204, Tacoma, WA 98402-5502 | 2020-05-06 |
| 1689225625 | Belinda Lyndon Montgomery | Peer Specialist | 1602 N Orchard St, Tacoma, WA 98406-3346 | 2019-09-20 |
| 1609242148 | Ashley Lorraine Dahlgren | Peer Specialist | 702 S 14th St., Tacoma, WA 98402 | 2015-08-19 |
| 1134727092 | Francena Taylor | Peer Specialist | 5410 N 44th St, Tacoma, WA 98407-3799 | 2020-10-13 |
| 1710584313 | Crystal Lee | Peer Specialist | 5410 N 44th St, Tacoma, WA 98407-3799 | 2020-10-06 |
| 1275146896 | Jamaica Myers | Peer Specialist | 5410 N 44th St, Tacoma, WA 98407-3799 | 2020-08-24 |
| 1003434812 | Maryann Hartman | Peer Specialist | 1305 Tacoma Ave S Ste 201, Tacoma, WA 98402-1903 | 2020-07-08 |
| 1851917991 | Prossy Nageri Balome | Peer Specialist | 721 Fawcett Ave Ste 100, Tacoma, WA 98402-5502 | 2020-06-24 |
| 1659997427 | Michaele Renee Trujillo | Peer Specialist | 5410 N 44th St, Tacoma, WA 98407-3799 | 2020-06-17 |
| 1083238307 | Juliana Desiree Darlene Amesquita | Peer Specialist | 5410 N 44th St, Tacoma, WA 98407-3799 | 2020-06-02 |
| Find all providers in TACOMA | ||||
Please comment or provide details below to improve the information on MR. JERRY DEAN BURTTS.
| 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.