Crystal Mazac

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

7972 Maple Ave SE
Snoqualmie, WA 98065

Phone

(425) 292-0743

NPI assigned

Dec 16, 2018

Last updated

Feb 19, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Friends of Youth

  • Community/Behavioral Health Agency
  • Snoqualmie, WA
  • NPI 1447552005
  NPD (past)

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550534400000",
    "number": "1366913519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7972 MAPLE AVE SE",
            "city": "SNOQUALMIE",
            "state": "WA",
            "postal_code": "98065",
            "telephone_number": "425-292-0743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7972 MAPLE AVE SE",
            "city": "SNOQUALMIE",
            "state": "WA",
            "postal_code": "98065",
            "telephone_number": "425-292-0743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZAC",
        "first_name": "CRYSTAL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-16",
        "last_updated": "2019-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "WA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CG60854932",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bryanna Mantilla, MD, PHD, MPH
• Kelvin G. Mar, M.D.
• Annamaria Marchionne, MD
• Asuncion Marquez
• Brian Elder Mayer, DDS PLLC
• Christa Michelle McAllister, CDP
• Amy M McCrery, RN
• Melissa McDonald, OTR/L
• Sierra McDowell-Nardine, SLP-CCC
• Anne Elizabeth McGavran, R.N.

• Counselor in Snoqualmie, WA
• Providers in Snoqualmie, WA by specialty
• Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2019; 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.