Individual provider Active NPI

Kathleen Teresa Young, MPT

  • Physical Therapist
  • Redmond, WA
National Provider Identifier
1750409439
Registry record updated Sep 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00007693 Issued in WA
Practice address
2569 152ND Ave NE
Redmond, WA 98052-5549
Phone
(425) 497-8180
Fax
(425) 497-8358
NPI assigned
Mar 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT00007693 WA Primary

Addresses

Primary practice location

2569 152ND Ave NE
Redmond, WA 98052-5549

Mailing address

11028 198TH PL SE
Snohomish, WA 98296-5041
Phone (425) 497-8180

Other identifiers 1

IdentifierTypeStateIssuer
8385742OtherWADHSH

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT00007693WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
PT Pro Inc. PastSince Sep 5, 2023 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": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190592000000",
    "number": "1750409439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11028 198TH PL SE",
            "city": "SNOHOMISH",
            "state": "WA",
            "postal_code": "982965041",
            "telephone_number": "425-497-8180",
            "fax_number": "425-497-8358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2569 152ND AVE NE",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980525549",
            "telephone_number": "425-497-8180",
            "fax_number": "425-497-8358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "KATHLEEN",
        "middle_name": "TERESA",
        "name_prefix": "Ms.",
        "credential": "MPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2007-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00007693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DHSH",
            "identifier": "8385742",
            "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 Sep 24, 2007; 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.