Individual provider Active NPI

Carson Douglas Seeber, M.D.

  • Family Medicine Physician
  • Clarkston, WA
National Provider Identifier
1861740300
Registry record updated Aug 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301101026 Issued in MI
Practice address
1119 Highland Ave
Suite a
Clarkston, WA 99403-2836
Phone
(509) 758-1450
Fax
(509) 751-1504
NPI assigned
Aug 15, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301101026 MI Primary

Addresses

Primary practice location

1119 Highland Ave
Suite a
Clarkston, WA 99403-2836

Mailing address

PO Box 189
Clarkston, WA 99403-0189
Phone (810) 347-2842

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, ID2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150701000789 WA Practitioner - Family Practice 0042530198 Reassigns benefits to 2 organizations
I20160308001328 ID Practitioner - Family Practice 0042530198 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-State Memorial Hospital Family Medicine CurrentSince Aug 1, 2015 Accepting new patients
Tri-State Memorial Hospital CurrentSince Jan 1, 2026 Accepting new patients
Tri-State Memorial Hospital Family Medicine CurrentSince Aug 1, 2015 Accepting new patients

Locations

415 6th St
Lewiston, ID 83501
Phone (208) 750-7445

2841 Juniper Dr
#2
Lewiston, ID 83501
Phone (208) 848-9001

1119 Highland Ave
Clarkston, WA 99403
Phone (509) 758-1450

1119 Highland Ave
Ste A
Clarkston, WA 99403
Phone (509) 758-1450

1119 Highland Ave
Ste 10
Clarkston, WA 99403
Phone (509) 758-1450

1221 Highland Ave
Clarkston, WA 99403
Phone (509) 751-0312

Interoperability endpoints

  • Direct secure messaging: carson.seeber@tsmh.medicity.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1344988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440460800000",
    "number": "1861740300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 189",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "994030189",
            "telephone_number": "810-347-2842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1119 HIGHLAND AVE",
            "address_2": "SUITE A",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "994032836",
            "telephone_number": "509-758-1450",
            "fax_number": "509-751-1504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEEBER",
        "first_name": "CARSON",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-15",
        "last_updated": "2015-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301101026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarkston, WA

Sources for this page

Verify at the official NPI Registry.