EVANDER SUJU (NPI# 1720696172) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720696172 |
| Entity Type | Individual |
| Full Name | EVANDER SUJU |
| Practice Address |
4910 N Bristol St Tacoma WA 98407-2124 |
| Practice Telephone | 2068199936 |
| Mailing Telephone | 2068199936 |
| Enumeration Date | 2020-07-21 |
| Last Update Date | 2020-07-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| Street Address |
4910 N BRISTOL ST |
| City | TACOMA |
| State | WA |
| Zip Code | 98407-2124 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871134205 | Adrienne Ashley | Behavior Technician | 3704 Nth 35th Street, Tacoma, WA 98407 | 2019-10-07 |
| 1346890050 | Theresa Marie Hopper | Technician | 5335 N. Ruby St., Tacoma, WA 98407 | 2019-09-14 |
| 1255894176 | Washington Dental Corporation, PC | Dentist | 2729 N Pearl St, Tacoma, WA 98407 | 2019-04-08 |
| 1518445196 | Rachael L Southern | Registered Nurse | 3502 N Visscher St, Tacoma, WA 98407 | 2018-08-06 |
| 1477082121 | Annalise Hertler | Case Manager/Care Coordinator | 5410 N 44th Street, Tacoma, WA 98407 | 2017-06-07 |
| 1720533805 | Edward Adlen Herrera | Behavioral Analyst | 3704 Nth 35th St, Tacoma, WA 98407 | 2016-08-18 |
| 1770945065 | Karen Schowalter | Family Medicine | 5741 N 26th St Unit 115, Tacoma, WA 98407 | 2016-03-24 |
| 1770950446 | Darriell Beaumonte | Counselor | 5410 N. 44th Street, Tacoma, WA 98407 | 2015-08-28 |
| 1750722682 | Lori Ha | Dentist | 5005 Main St Ste 107, Ruston, WA 98407 | 2013-07-08 |
| 1861745929 | Jennifer L Trahan | Counselor | 5410 N. 44th St., Tacoma, WA 98407 | 2012-10-25 |
| Find all providers in zip 98407 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306445614 | Danica Thomas | Counselor | 415 S 13th St, Tacoma, WA 98402-3415 | 2020-10-19 |
| 1033732615 | Mary Amanda Graham | Counselor | 510 S 35th St, Tacoma, WA 98418-6824 | 2020-05-18 |
| 1043831258 | Christine Marie Petersen | Counselor | 601 136th St E, Tacoma, WA 98445-1563 | 2020-04-28 |
| 1841835436 | Michael Roy Bolden | Counselor | 1205 Tacoma Ave S., Suite 1205, Tacoma, WA 98402 | 2019-11-07 |
| 1568016731 | Gabriella Salas-trujillo | Counselor | 3109 N 7th St, Tacoma, WA 98406-6218 | 2019-07-26 |
| 1124686290 | Emmanuel Villarivera | Counselor | 612 113th St S, Tacoma, WA 98444-4902 | 2019-06-03 |
| 1588227094 | Aimee Lauren Peyton-greene | Counselor | 6621 S Wapato St, Tacoma, WA 98409-9082 | 2019-04-19 |
| 1679037535 | Sapati Siose | Counselor | 4021 S Bell St, Tacoma, WA 98418-7820 | 2019-01-24 |
| 1255849980 | Rodney D Terry | Counselor | 4509 S Union Ave Apt 3, Tacoma, WA 98409-4508 | 2018-01-16 |
| 1346769528 | Karin Lynn Escobar | Counselor | 1201 South Proctor Street, Tacoma, WA 98405 | 2017-09-19 |
| Find all providers in TACOMA | ||||
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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.