Individual
CARISSE M YOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
13221 NE 109TH PL, REDMOND, WA 98052-2407
(425) 736-9389
Mailing address
13221 NE 109TH PL, REDMOND, WA 98052-2407
(425) 736-9389
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
00020200
WA
225700000X
Massage Therapist
Primary
MA00020200
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0141356
DEPT. LABOR & INDUSTRIES
WA
Enumeration date
11/21/2005
Last updated
11/05/2019
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