Individual provider Active NPI

Karissa Walker Shiraishi

  • Pediatric Physical Therapist
  • Kirkland, WA
National Provider Identifier
1942715438
Registry record updated Apr 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
Practice address
12911 120TH Ave NE Ste E60
Kirkland, WA 98034
Phone
(425) 298-7190
NPI assigned
Dec 6, 2017
Last updated
Apr 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X NU Primary

Addresses

Primary practice location

12911 120TH Ave NE Ste E60
Kirkland, WA 98034

Mailing address

1004 Kirkland Ave # A7
Kirkland, WA 98033-6349
Phone (206) 841-8204

Other practice location 1

20818 44th Ave W Ste 270
Lynnwood, WA 98036-7709
Phone (425) 672-2716

Other practice location 2

710 NW Juniper St Ste 104
Issaquah, WA 98027-2717
Phone (425) 392-7989

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

Practice roles

OrganizationSpecialtyStatusNew patients
RWW Pediatric Rehab Services LLC PastSince Aug 1, 2019 Accepting new patients
Northwest Pediatric Therapies, PS PastSince Aug 1, 2019 Accepting new patients
Center for Prosthetics Orthotics, Inc. PastSince Apr 11, 2021 Accepting new patients

Organizations & group practices 4

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": "1512518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1942715438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 KIRKLAND AVE # A7",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980336349",
            "telephone_number": "206-841-8204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12911 120TH AVE NE STE E60",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "98034",
            "telephone_number": "425-298-7190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20818 44th Ave W Ste 270",
            "address_purpose": "LOCATION",
            "city": "Lynnwood",
            "state": "WA",
            "postal_code": "980367709",
            "country_code": "US",
            "telephone_number": "425-672-2716",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "710 NW Juniper St Ste 104",
            "address_purpose": "LOCATION",
            "city": "Issaquah",
            "state": "WA",
            "postal_code": "980272717",
            "country_code": "US",
            "telephone_number": "425-392-7989",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIRAISHI",
        "first_name": "KARISSA",
        "middle_name": "WALKER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-06",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2021; 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.