NPIMap

Organization Active NPI

Crysalis, LLC

Doing business as Crysalis Wellness Center

  • Specialist
  • Seattle, WA
National Provider Identifier
1164736104
Registry record updated Aug 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA00005185 Issued in WA
Legal business name
CRYSALIS, LLC
Doing business as
Crysalis Wellness Center
Practice address
800 5TH Ave
Suite 200
Seattle, WA 98104-3176
Phone
(206) 407-3068
NPI assigned
Aug 2, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Kathleen J. Reust, LMP
Title
Partner
Phone
(206) 407-3068

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X WA
NutritionistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 133N00000X
AcupuncturistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 171100000X
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X MA00005185 WA Primary
NaturopathGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 175F00000X

Addresses

Primary practice location

800 5TH Ave
Suite 200
Seattle, WA 98104-3176

Mailing address

700 5TH Ave
Suite 606
Seattle, WA 98104-5058

Other names 1

  • Crysalis Wellness Center Doing business as

National Provider Directory

National Provider Directory

Locations

700 5th Ave
Ste 606
Seattle, WA 98104

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1280707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280707200000",
    "number": "1164736104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 5TH AVE",
            "address_2": "SUITE 606",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981045058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 5TH AVE",
            "address_2": "SUITE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981043176",
            "telephone_number": "206-407-3068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSALIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-02",
        "last_updated": "2010-08-02",
        "status": "A",
        "authorized_official_last_name": "REUST",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "206-407-3068",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMP"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA00005185",
            "primary": true
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Naturopath",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crysalis Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.