WENDELL MIDDLEBROOKS (NPI# 1356810790) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356810790 |
| Entity Type | Individual |
| Full Name | WENDELL MIDDLEBROOKS |
| Practice Address |
2150 Freeman Rd E Fife WA 98424-3776 |
| Practice Telephone | 2539425644 |
| Practice Fax Number | 2532355216 |
| Mailing Telephone | 2539425644 |
| Mailing Fax Number | 2532355216 |
| Enumeration Date | 2018-11-15 |
| Last Update Date | 2018-12-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| Street Address |
2150 FREEMAN RD E |
| City | FIFE |
| State | WA |
| Zip Code | 98424-3776 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376012930 | Judi Lynn Ball | Peer Specialist | 2150 Freeman Rd E, Fife, WA 98424-3776 | 2018-11-13 |
| 1386250512 | Jane Nyaguthii Tellis | Nurse Practitioner | 2150 Freeman Rd E, Fife, WA 98424-3776 | 2020-09-22 |
| 1932717733 | Tommy Soeum | Counselor | 2150 Freeman Rd E, Fife, WA 98424-3776 | 2020-07-17 |
| 1265058416 | Patricia Wachuka Waithaka | Home Health Aide | 2150 Freeman Rd E, Fife, WA 98424-3776 | 2020-06-23 |
| 1801412572 | Anna-marie Pence | Registered Nurse | 2150 Freeman Rd E, Fife, WA 98424-3776 | 2020-06-18 |
| 1083230767 | Aana Sundling | Counselor | 2150 Freeman Rd E, Fife, WA 98424-3776 | 2020-06-18 |
| 1639795305 | Kevlin Slingwine | Registered Nurse | 2150 Freeman Rd E, Fife, WA 98424-3776 | 2020-06-18 |
| 1831714609 | Sean Loucks | Counselor | 2150 Freeman Rd E, Fife, WA 98424-3776 | 2020-06-08 |
| 1992320766 | Laura Love | Counselor | 2150 Freeman Rd E, Fife, WA 98424-3776 | 2020-06-08 |
| 1376167619 | Jennifer Jane Beaman-mcgee | Counselor | 2150 Freeman Rd E, Fife, WA 98424-3776 | 2020-06-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619447265 | Rachael E Vosika | Peer Specialist | 4210 20th St E Suite B&c, Fife, WA 98424 | 2018-11-27 |
| 1477023026 | Julie Ann Sawyer | Registered Nurse | 2150 Freeman Road East Ste 1, Fife, WA 98424 | 2018-11-27 |
| 1831668409 | Dorothy J Pierce | Counselor | 4210 20th St E Ste C, Fife, WA 98424 | 2018-11-13 |
| 1730606328 | Caitlin Anne Gallup | Specialist/Technologist | 4703 Pacific Hwy E Ste B, Fife, WA 98424 | 2017-08-24 |
| 1497121420 | Lane Whitaker Valentine | Massage Therapist | 6523 20th St E #4, Fife, WA 98424 | 2015-08-13 |
| 1609250646 | Enna Alexandra Codekas | Speech-Language Pathologist | 535 Dock Street, Suite 104, Tacoma, WA 98424 | 2015-07-18 |
| 1457608002 | Timothy Edward Day | Pharmacist | 522 64th Avenue Ct E, Fife, WA 98424 | 2012-08-13 |
| 1861768400 | Ryan Milo Glover | Pharmacist | 3700 Pacific Highway East, Suite 100, Fife, WA 98424 | 2012-03-28 |
| 1962794719 | Hongbunareth Hirata | Massage Therapist | 6329 Discovery St E, Fife, WA 98424 | 2011-05-12 |
| 1811155930 | Mvp Physical Therapy, Inc. | Massage Therapist | 502 54th Ave. E., Fife, WA 98424 | 2008-05-27 |
| Find all providers in zip 98424 | ||||
| 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 |
|---|---|---|---|---|
| 1619447265 | Rachael E Vosika | Peer Specialist | 4210 20th St E Suite B&c, Fife, WA 98424 | 2018-11-27 |
| 1013486570 | Kerry Duvent | Peer Specialist | 4210 20th St E Ste Bcef, Fife, WA 98424-1830 | 2018-11-14 |
| 1043789506 | Mare Dumas-graig | Peer Specialist | 4210 20th St E Ste Bcfe, Fife, WA 98424-1830 | 2018-11-14 |
| 1376012930 | Judi Lynn Ball | Peer Specialist | 2150 Freeman Rd E, Fife, WA 98424-3776 | 2018-11-13 |
| 1396393765 | John Michael Murphy IIi | Peer Specialist | 2150 Freeman Rd E, Fife, WA 98424-3776 | 2019-08-29 |
| 1598317836 | Maxine Harleaux | Peer Specialist | 2150 Freeman Rd E Ste 1, Fife, WA 98424-3776 | 2019-07-16 |
| 1891352233 | Sean Contris | Peer Specialist | 2150 Freeman Rd E, Fife, WA 98424-3776 | 2019-05-21 |
| 1326505587 | Rochel Borja | Peer Specialist | 2150 Freeman Rd E Ste 1, Fife, WA 98424-3776 | 2019-02-25 |
| 1912464355 | David Zumwalt | Peer Specialist | 2150 Freeman Rd E, Fife, WA 98424-3776 | 2019-02-21 |
| 1073070413 | Stephen Searight | Peer Specialist | 2150 Freeman Rd E, Fife, WA 98424-3776 | 2019-02-21 |
| Find all providers in FIFE | ||||
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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.