Individual provider Active NPI

Seamus McGregor Carroll

  • Speech-Language Assistant
  • Shoreline, WA
National Provider Identifier
1356100309
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
61388373 Issued in WA
Practice address
16516 10TH Ave NE
Shoreline, WA 98155-5904
Phone
(206) 393-4272
NPI assigned
Mar 13, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X 61388373 WA Primary

Addresses

Primary practice location

16516 10TH Ave NE
Shoreline, WA 98155-5904

Mailing address

1216 N Pine St
Tacoma, WA 98406-6914
Phone (253) 341-9042

Other practice location 1

1515 S Fruitland
Puyallup, WA 98371-7399
Phone (253) 841-8734

Other practice location 2

15102 122nd Ave E
Puyallup, WA 98374-3419
Phone (253) 841-8755

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
61388373WAMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1710288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1356100309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1216 N PINE ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984066914",
            "telephone_number": "253-341-9042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16516 10TH AVE NE",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981555904",
            "telephone_number": "206-393-4272"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1515 S Fruitland",
            "address_purpose": "LOCATION",
            "city": "Puyallup",
            "state": "WA",
            "postal_code": "983717399",
            "country_code": "US",
            "telephone_number": "253-841-8734",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15102 122nd Ave E",
            "address_purpose": "LOCATION",
            "city": "Puyallup",
            "state": "WA",
            "postal_code": "983743419",
            "country_code": "US",
            "telephone_number": "253-841-8755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "SEAMUS",
        "middle_name": "MCGREGOR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-03-13",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "WA",
            "license": "61388373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreline, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; 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.