MR. JEREMIAH SHANE DUNLAP SUDP NPI 1336515964

NPI Information

  • NPI: 1336515964
  • Provider Name: MR. JEREMIAH SHANE DUNLAP, SUDP
  • Classification: Counselor - 101YA0400X
  • Specialization: Addiction (Substance Use Disorder)
  • Entity Type: Individual
  • Address: 18208 113TH AVE E
    PUYALLUP, WA
    ZIP 98374
  • Phone: (253) 359-3219

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NPI Details

MR. Jeremiah Shane Dunlap, SUDP is an addiction (substance use disorder) counselor in Puyallup, WA. MR. Jeremiah Shane Dunlap, SUDP NPI is 1336515964. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

18208 113TH AVE E
PUYALLUP, WA
ZIP 98374-854
Phone: (253) 359-3219

The enumeration date for this NPI number is 8/18/2015 and was last updated on 2/18/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YM0800XCounselorMental HealthCP60556714WASHINGTONNo
2101YA0400XCounselorAddiction (Substance Use Disorder)CP60556714WASHINGTONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1CP60556714OTHERWASHINGTONCHEMICAL DEPENDANCY PROFESSIONAL
241614MEDICAIDWASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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