HAROLD JAMES LUNDGREN (NPI# 1427526276) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427526276 |
| Entity Type | Individual |
| Full Name | HAROLD JAMES LUNDGREN |
| Practice Address |
5901 N Lidgerwood St Ste 115 Spokane WA 99208-1122 |
| Mailing Address |
107 S Division St Spokane WA 99202-1510 |
| Practice Telephone | 5098384651 |
| Mailing Telephone | 5098384651 |
| Enumeration Date | 2018-11-09 |
| Last Update Date | 2020-02-05 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | CG60531421 | WA | Behavioral Health & Social Service Providers |
| Y | 175T00000X | Peer Specialist | CG60531421 | WA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 2114445 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 124 E Short Ave, Spokane, WA 992021555 | 5098384651 |
| Street Address |
5901 N LIDGERWOOD ST STE 115 |
| City | SPOKANE |
| State | WA |
| Zip Code | 99208-1122 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720537475 | Kyle Shane Bailey | Counselor | 5901 N Lidgerwood St Ste 115, Spokane, WA 99208-1122 | 2016-09-22 |
| 1720686199 | Rebecca Ann Martinez | Student in an Organized Health Care Education/Training Program | 5901 N Lidgerwood St Ste 115, Spokane, WA 99208-1122 | 2020-10-16 |
| 1093313975 | Rebekah Hagreen | Student in an Organized Health Care Education/Training Program | 5901 N Lidgerwood St Ste 115, Spokane, WA 99208-1122 | 2020-10-13 |
| 1851999734 | Hannah Nickerson-scully | Student in an Organized Health Care Education/Training Program | 5901 N Lidgerwood St Ste 115, Spokane, WA 99208-1122 | 2020-10-13 |
| 1841898996 | Matthew J Morris | Student in an Organized Health Care Education/Training Program | 5901 N Lidgerwood St Ste 115, Spokane, WA 99208-1122 | 2020-10-12 |
| 1437770443 | Hector Manuel Aguila Jr. | Student in an Organized Health Care Education/Training Program | 5901 N Lidgerwood St Ste 115, Spokane, WA 99208-1122 | 2020-04-30 |
| 1124653852 | Sarah Buchanan Walsh | Student in an Organized Health Care Education/Training Program | 5901 N Lidgerwood St Ste 115, Spokane, WA 99208-1122 | 2020-03-03 |
| 1679107395 | Nicole Lynae Jarrett | Student in an Organized Health Care Education/Training Program | 5901 N Lidgerwood St Ste 115, Spokane, WA 99208-1122 | 2020-03-03 |
| 1033749767 | Regina Christine Rich | Student in an Organized Health Care Education/Training Program | 5901 N Lidgerwood St Ste 115, Spokane, WA 99208-1122 | 2020-01-22 |
| 1497394092 | Katarina Chantel Johnson | Student in an Organized Health Care Education/Training Program | 5901 N Lidgerwood St Ste 115, Spokane, WA 99208-1122 | 2019-12-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043787161 | Bonnie Rose Spencer | Social Worker | E 44 Cozza, Spokane, WA 99208 | 2018-10-26 |
| 1235617515 | Melissa Dawn Scholl | Massage Therapist | 906 E Country Hill Ct, Spokane, WA 99208 | 2018-07-30 |
| 1043706583 | Healthy Schools Washington, Pllc | Pediatrics | 1028 West Rosewood Ave, Spokane, WA 99208 | 2018-07-09 |
| 1467943720 | Simone Ferguson | Student in an Organized Health Care Education/Training Program | 7808 North Morton Avenue, Apt. # 675, Spokane, WA 99208 | 2018-05-22 |
| 1912496035 | Ascend Network Corp | Counselor | 3711 W Woodside, Spokane, WA 99208 | 2018-05-03 |
| 1023522216 | Cherrywood Place-spokane, LLC | Assisted Living Facility | 100 East Dalke Ave, Spokane, WA 99208 | 2017-11-27 |
| 1881118792 | Annie Kamau | Registered Nurse | 5920 W Lonewolf, Spokane, WA 99208 | 2017-08-01 |
| 1609303908 | Jeffery Anthony Glinski | Counselor | 3754 W. Indian Trail Rd., Spokane, WA 99208 | 2017-05-17 |
| 1487186938 | Mukhlis Azar | Physical Therapy Assistant | 305 E Sierra Ct, Spokane, WA 99208 | 2017-04-03 |
| 1154796241 | Daisy O'dell | Marriage & Family Therapist | 515 W. Francis Ave., Suite #8, Spokane, WA 99208 | 2015-12-01 |
| Find all providers in zip 99208 | ||||
| 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 |
|---|---|---|---|---|
| 1043856123 | Jayde Wailani Albright | Peer Specialist | 5920 N Calispel St, Spokane, WA 99205-6214 | 2019-11-23 |
| 1649732793 | Marsha Rose Valenzuela | Peer Specialist | Partners With Families and Children, 1321 W. Broadway, Spokane, WA 99201 | 2019-04-05 |
| 1083199673 | Kimberly Sue Williams | Peer Specialist | 4913 W Lamar Ave, Spokane, WA 99208-9131 | 2018-09-28 |
| 1619477031 | Mark Todd Stucker | Peer Specialist | 12 E 5th Ave # 2253, Spokane, WA 99202-1309 | 2018-02-13 |
| 1306459813 | Eva R Perez | Peer Specialist | 1700 S Assembly St Ste 300, Spokane, WA 99224-2116 | 2020-08-25 |
| 1255943627 | Dylan Ramirez | Peer Specialist | 3754 W Indian Trail Rd, Spokane, WA 99208-4736 | 2020-08-18 |
| 1922626159 | Chelsa Lene Mcdaniel | Peer Specialist | 2222 N Monroe St, Spokane, WA 99205-4545 | 2020-07-14 |
| 1295353415 | David M Domreis | Peer Specialist | 2222 N Monroe St, Spokane, WA 99205-4545 | 2020-07-14 |
| 1386260313 | Dom Demetrio Felxi | Peer Specialist | 2222 N Monroe St, Spokane, WA 99205-4545 | 2020-06-25 |
| 1457973166 | Natalie J Willis | Peer Specialist | 2222 N Monroe St, Spokane, WA 99205-4545 | 2020-05-15 |
| Find all providers in SPOKANE | ||||
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| 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.