Active NPI
Doug Young, CPO
- Prosthetist
- Sequim, WA
National Provider Identifier
1265752612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetist
- License
- PS00000121
- Practice address
- 566 N 5TH Ave
Sequim, WA 98382-3079 - Phone
- (360) 797-1001
- Fax
- (360) 797-1003
- NPI assigned
- Jun 8, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthotist | 222Z00000X | OI00000122 | WA | |
| Prosthetist | 224P00000X | PS00000121 | WA | Primary |
Addresses
Primary practice location
566 N 5TH Ave
Sequim, WA 98382-3079
Mailing address
1300 44TH St SE
Everett, WA 98203-2200
Phone (425) 339-2559
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OI00000122 | WA | MD | Orthotist |
| PS00000121 | WA | MD | Prosthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1275955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1275955200000",
"number": "1265752612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1300 44TH ST SE",
"city": "EVERETT",
"state": "WA",
"postal_code": "982032200",
"telephone_number": "425-339-2559",
"fax_number": "425-339-1583"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "566 N 5TH AVE",
"city": "SEQUIM",
"state": "WA",
"postal_code": "983823079",
"telephone_number": "360-797-1001",
"fax_number": "360-797-1003"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "DOUG",
"credential": "CPO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-06-08",
"last_updated": "2010-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "222Z00000X",
"taxonomy_group": "",
"desc": "Orthotist",
"state": "WA",
"license": "OI00000122",
"primary": false
},
{
"code": "224P00000X",
"taxonomy_group": "",
"desc": "Prosthetist",
"state": "WA",
"license": "PS00000121",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sequim, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.