Individual provider Active NPI

Caroline Rae Wait

  • Other Technician
  • Seattle, WA
National Provider Identifier
1245687300
Registry record updated May 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Other TechnicianTaxonomy code 247200000X
Practice address
1100 Dexter Ave N
100
Seattle, WA 98109-3598
Phone
(772) 675-9100
NPI assigned
May 18, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X
Other Technician 247200000X Primary

Addresses

Primary practice location

1100 Dexter Ave N
100
Seattle, WA 98109-3598

Mailing address

3105 Tullibee Cir Apt P2
Silverdale, WA 98315-9716
Phone (303) 856-5299

Other names 1

  • Caroline Conklin Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463529600000",
    "number": "1245687300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3105 TULLIBEE CIR APT P2",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983159716",
            "telephone_number": "303-856-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 DEXTER AVE N",
            "address_2": "100",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981093598",
            "telephone_number": "772-675-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAIT",
        "first_name": "CAROLINE",
        "middle_name": "RAE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-18",
        "last_updated": "2016-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLINE",
            "last_name": "CONKLIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 May 18, 2016; 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.