Individual provider Active NPI

Tessa Brydon-Yelton, DIPL.OM

  • Acupuncturist
  • Issaquah, WA
National Provider Identifier
1962263434
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC61516331 Issued in WA
Practice address
450 NW Gilman Blvd Ste 201
Issaquah, WA 98027-2722
Phone
(425) 835-2503
NPI assigned
Jan 22, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC61516331 WA Primary

Addresses

Primary practice location

450 NW Gilman Blvd Ste 201
Issaquah, WA 98027-2722

Mailing address

9412 SE 33Rd St
Mercer Island, WA 98040-3112

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
AC61516331WAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1705881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1962263434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9412 SE 33RD ST",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "980403112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 NW GILMAN BLVD STE 201",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272722",
            "telephone_number": "425-835-2503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYDON-YELTON",
        "first_name": "TESSA",
        "credential": "DIPL.OM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-22",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "WA",
            "license": "AC61516331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 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.

Verify at the official NPI Registry.