Individual provider Active NPI

Karissa Botset, LPN

  • Licensed Practical Nurse
  • Lakebay, WA
National Provider Identifier
1346043619
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LP61274753 Issued in WA
Practice address
9115 154TH Avenue CT NW
Lakebay, WA 98349-9850
Phone
(253) 649-5080
Fax
(360) 252-7016
NPI assigned
Mar 31, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LP101070 GA
Licensed Practical Nurse 164W00000X LP61274753 WA Primary

Addresses

Primary practice location

9115 154TH Avenue CT NW
Lakebay, WA 98349-9850

Mailing address

2128 69TH Ave W # E107
University Place, WA 98466-5856
Phone (813) 480-6498

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

LicenseStateTypeSpecialty
LP101070GAMDLicensed Practical Nurse
LP61274753WAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1743379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1346043619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2128 69TH AVE W # E107",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984665856",
            "telephone_number": "813-480-6498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9115 154TH AVENUE CT NW",
            "city": "LAKEBAY",
            "state": "WA",
            "postal_code": "983499850",
            "telephone_number": "253-649-5080",
            "fax_number": "360-252-7016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTSET",
        "first_name": "KARISSA",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-31",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "LP101070",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WA",
            "license": "LP61274753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakebay, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2025; 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.