Active NPI
Alexis Taylor, COSMETIC TATTOO
- Other Technician
- Richland, WA
National Provider Identifier
1649911439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- License
- 604655365-001-0001
- Practice address
- 303 Casey Ave Ste a
Richland, WA 99352-4301 - Phone
- (509) 713-5561
- NPI assigned
- Apr 5, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Other Technician | 247200000X | 604655365-001-0001 | WA | Primary |
Addresses
Primary practice location
303 Casey Ave Ste a
Richland, WA 99352-4301
Mailing address
3108 S Lyle St
Kennewick, WA 99337-4448
Phone (509) 713-5561
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 |
|---|---|---|---|
| 604655365-001-0001 | WA | MD | Other Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649116800000",
"number": "1649911439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3108 S LYLE ST",
"city": "KENNEWICK",
"state": "WA",
"postal_code": "993374448",
"telephone_number": "509-713-5561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "303 CASEY AVE STE A",
"city": "RICHLAND",
"state": "WA",
"postal_code": "993524301",
"telephone_number": "509-713-5561"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAYLOR",
"first_name": "ALEXIS",
"credential": "COSMETIC TATTOO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-04-05",
"last_updated": "2022-04-05",
"certification_date": "2022-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "WA",
"license": "604655365-001-0001",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richland, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.