Organization Active NPI

First Step Pediatric Therapy, LLC

  • Physical Therapist
  • Kirkland, WA
National Provider Identifier
1407465388
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
FIRST STEP PEDIATRIC THERAPY, LLC
Practice address
12911 120TH Ave NE Ste E60
Kirkland, WA 98034-3047
Phone
(425) 298-7190
NPI assigned
Jul 28, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2021

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

Authorized official

Name
Karissa Shiraishi, PT, DPT
Title
Physical Therapist
Phone
(206) 841-8204

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

12911 120TH Ave NE Ste E60
Kirkland, WA 98034-3047

Mailing address

1004 Kirkland Ave Apt 7
Kirkland, WA 98033-6351
Phone (206) 841-8204

Other practice location 1

1004 Kirkland Ave Apt 7
Kirkland, WA 98033-6351
Phone (206) 841-8204

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210421000787 WA Part B Supplier - Clinic/Group Practice 1557779188 Practice locations: Kirkland, WA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1595894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616457600000",
    "number": "1407465388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 KIRKLAND AVE APT 7",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980336351",
            "telephone_number": "206-841-8204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12911 120TH AVE NE STE E60",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343047",
            "telephone_number": "425-298-7190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1004 Kirkland Ave Apt 7",
            "address_purpose": "LOCATION",
            "city": "Kirkland",
            "state": "WA",
            "postal_code": "980336351",
            "country_code": "US",
            "telephone_number": "206-841-8204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FIRST STEP PEDIATRIC THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-28",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A",
        "authorized_official_last_name": "SHIRAISHI",
        "authorized_official_first_name": "KARISSA",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "206-841-8204",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.