Provider Demographics
NPI:1184615460
Name:YOUNG, STEVEN KENNETH (CSA)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:KENNETH
Last Name:YOUNG
Suffix:
Gender:M
Credentials:CSA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2030 280TH PL NE
Mailing Address - Street 2:
Mailing Address - City:CARNATION
Mailing Address - State:WA
Mailing Address - Zip Code:98014-8218
Mailing Address - Country:US
Mailing Address - Phone:425-333-4434
Mailing Address - Fax:425-333-4462
Practice Address - Street 1:2030 280TH PL NE
Practice Address - Street 2:
Practice Address - City:CARNATION
Practice Address - State:WA
Practice Address - Zip Code:98014-8218
Practice Address - Country:US
Practice Address - Phone:425-333-4434
Practice Address - Fax:425-333-4462
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2014-12-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXSA 00157363AS0400X
WAST00001591363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical