Individual provider Active NPI

Crisey P Doughty, MEDICAL ASSISTANT

  • Nurse's Aide
  • Seattle, WA
National Provider Identifier
1790254696
Registry record updated Nov 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
HT60363744 Issued in WA
Practice address
10344 14TH Ave S
Seattle, WA 98168-1689
Phone
(206) 245-1086
NPI assigned
Nov 20, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X HT60363744 WA Primary

Addresses

Primary practice location

10344 14TH Ave S
Seattle, WA 98168-1689

Mailing address

11606 183Rd St E
Puyallup, WA 98374-8872
Phone (253) 740-6446

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
HT60363744WAMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1542672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542672000000",
    "number": "1790254696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11606 183RD ST E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983748872",
            "telephone_number": "253-740-6446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10344 14TH AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981681689",
            "telephone_number": "206-245-1086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHTY",
        "first_name": "CRISEY",
        "middle_name": "P",
        "credential": "MEDICAL ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-20",
        "last_updated": "2018-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "WA",
            "license": "HT60363744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2018; 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.