Active NPI
Ivy Garrett, LAC
- Acupuncturist
- Kenmore, WA
National Provider Identifier
1922848183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC61553512
- Practice address
- 14500 Juanita Dr NE
Kenmore, WA 98028-4966 - Phone
- (208) 569-9964
- NPI assigned
- May 27, 2024
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Acupuncturist | 171100000X | AC61553512 | WA | Primary |
Addresses
Primary practice location
14500 Juanita Dr NE
Kenmore, WA 98028-4966
Mailing address
14500 Juanita Dr NE
Kenmore, WA 98028-4966
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 |
|---|---|---|---|
| AC61553512 | WA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1716768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716768000000",
"number": "1922848183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14500 JUANITA DR NE",
"city": "KENMORE",
"state": "WA",
"postal_code": "980284966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14500 JUANITA DR NE",
"city": "KENMORE",
"state": "WA",
"postal_code": "980284966",
"telephone_number": "208-569-9964"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARRETT",
"first_name": "IVY",
"credential": "LAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-05-27",
"last_updated": "2024-05-27",
"certification_date": "2024-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "WA",
"license": "AC61553512",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kenmore, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.