Active NPI
Mary Young, CCC-SLP
- Audiologist
- Covington, WA
National Provider Identifier
1366467318
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- LL00002874
- Practice address
- 17700 SE 272ND St
Covington, WA 98042-4951 - Phone
- (253) 372-7030
- NPI assigned
- Jul 12, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | LL00002874 | WA | Primary |
Addresses
Primary practice location
17700 SE 272ND St
Covington, WA 98042-4951
Mailing address
PO Box 5299
Ms: 737-2-Phys
Tacoma, WA 98415-0299
Phone (253) 459-7970
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 |
|---|---|---|---|
| LL00002874 | WA | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1366467318",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5299",
"address_2": "MS: 737-2-PHYS",
"city": "TACOMA",
"state": "WA",
"postal_code": "984150299",
"telephone_number": "253-459-7970"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17700 SE 272ND ST",
"city": "COVINGTON",
"state": "WA",
"postal_code": "980424951",
"telephone_number": "253-372-7030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "MARY",
"credential": "CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "WA",
"license": "LL00002874",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Covington, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.