Individual provider Active NPI

Carisse M Young, LMP

  • Massage Therapist
  • Redmond, WA
National Provider Identifier
1619950094
Registry record updated Nov 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00020200 Issued in WA
Practice address
13221 NE 109TH PL
Redmond, WA 98052-2407
Phone
(425) 736-9389
NPI assigned
Nov 21, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA00020200 WA Primary
Massage Therapist 225700000X 00020200 WA

Addresses

Primary practice location

13221 NE 109TH PL
Redmond, WA 98052-2407

Mailing address

13221 NE 109TH PL
Redmond, WA 98052-2407
Phone (425) 736-9389

Other practice location 1

12015 NE 8th St
Suite #1
Bellevue, WA 98005-3141
Phone (425) 635-0544

Other identifiers 1

IdentifierTypeStateIssuer
0141356OtherWADEPT. LABOR & INDUSTRIES

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
00020200WAMDMassage Therapist
MA00020200WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas C. Schwartz, DC, PS, Inc. Past Accepting new patients

Organizations & group practices 1

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": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572912000000",
    "number": "1619950094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13221 NE 109TH PL",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980522407",
            "telephone_number": "425-736-9389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13221 NE 109TH PL",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980522407",
            "telephone_number": "425-736-9389"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12015 NE 8th St",
            "address_2": "Suite #1",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WA",
            "postal_code": "980053141",
            "country_code": "US",
            "telephone_number": "425-635-0544",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "CARISSE",
        "middle_name": "M",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-21",
        "last_updated": "2019-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00020200",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "00020200",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT. LABOR & INDUSTRIES",
            "identifier": "0141356",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.