Individual provider Active NPI

Crisida Dela Cruz-Yaya

  • Student in an Organized Health Care Education/Training Program
  • Tacoma, WA
National Provider Identifier
1396613063
Registry record updated Apr 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1112 S Cushman Ave
Tacoma, WA 98405-3631
Phone
(253) 593-2144
NPI assigned
Oct 25, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X WA Primary

Addresses

Primary practice location

1112 S Cushman Ave
Tacoma, WA 98405-3631

Mailing address

9710 State Ave
Marysville, WA 98270-2232

Other practice location 1

7410 Delaware Ln Uppr Level
Vancouver, WA 98664-1408
Phone (360) 566-4402

Other practice location 2

9710 State Ave
Marysville, WA 98270-2232
Phone (360) 653-1742

Other practice location 3

4111 Alderwood Mall Blvd
Lynnwood, WA 98036-6765
Phone (425) 616-4100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260402002393 WA Practitioner - Family Practice 7012492465 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Seattle, WA 98124

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sea-Mar Community Health Center Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1761350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775692800000",
    "number": "1396613063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9710 STATE AVE",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982702232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 S CUSHMAN AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984053631",
            "telephone_number": "253-593-2144"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7410 Delaware Ln Uppr Level",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986641408",
            "country_code": "US",
            "telephone_number": "360-566-4402",
            "fax_number": "360-566-4406",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9710 State Ave",
            "address_purpose": "LOCATION",
            "city": "Marysville",
            "state": "WA",
            "postal_code": "982702232",
            "country_code": "US",
            "telephone_number": "360-653-1742",
            "fax_number": "360-657-3095",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4111 Alderwood Mall Blvd",
            "address_purpose": "LOCATION",
            "city": "Lynnwood",
            "state": "WA",
            "postal_code": "980366765",
            "country_code": "US",
            "telephone_number": "425-616-4100",
            "fax_number": "425-616-4115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DELA CRUZ-YAYA",
        "first_name": "CRISIDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-25",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.