Healthcare Provider Details

I. General information

NPI: 1780574541
Provider Name (Legal Business Name): CARRIE YOUNG BSN, RN, CRRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2025
Last Update Date: 07/03/2025
Certification Date: 07/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16101 BOTHELL EVERETT HWY UNIT E107
MILL CREEK WA
98012-1732
US

IV. Provider business mailing address

16101 BOTHELL EVERETT HWY UNIT E107
MILL CREEK WA
98012-1732
US

V. Phone/Fax

Practice location:
  • Phone: 808-203-8737
  • Fax:
Mailing address:
  • Phone: 808-203-8737
  • Fax: 808-203-8737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN60162243
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: