Carl Youngstrom, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MD00014591 Issued in WA

Practice address

3911 Castlevale Rd
Suite 105
Yakima, WA 98902-7807

Phone

(509) 575-7652

Fax

(509) 575-3658

NPI assigned

Oct 10, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Diagnostic Vascular Laboratory, LLC

  • Physiological Laboratory
  • Yakima, WA
  • NPI 1023154465
  NPD (past)

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780772434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3911 CASTLEVALE RD",
            "address_2": "SUITE 105",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989027807",
            "telephone_number": "509-575-7652",
            "fax_number": "509-575-3658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3911 CASTLEVALE RD",
            "address_2": "SUITE 105",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989027807",
            "telephone_number": "509-575-7652",
            "fax_number": "509-575-3658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNGSTROM",
        "first_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD00014591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7017049",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Carmen Young
• Mark C Young, DDS INC
• Morgan Ashleigh Young, D.O.
• Peter R Young Jr., M.D.
• Philip Ryan Young, ARNP
• Eric A Youngstrom, MD
• Stephen Allen Younker, ED.D.
• Yvfwc-Behavioral Health Services
• Valerie Zabell, RDN
• John Raymond Zambito, D.O.

• Surgery Physician in Yakima, WA
• Providers in Yakima, WA by specialty
• Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.