Active NPI
Grace Fredeen, CO
- Orthotist
- Seattle, WA
National Provider Identifier
1003008137
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthotist
- License
- OI00000178
- Practice address
- 600 Broadway
Suite 190
Seattle, WA 98122-5395 - Phone
- (206) 323-4040
- Fax
- (206) 324-0943
- NPI assigned
- Aug 13, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthotist | 222Z00000X | OI00000178 | WA | Primary |
Addresses
Primary practice location
600 Broadway
Suite 190
Seattle, WA 98122-5395
Mailing address
600 Broadway
Suite 190
Seattle, WA 98122-5395
Phone (206) 323-4040
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9036963 | Medicaid | WA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| OI00000178 | WA | MD | Orthotist |
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/mQjCqHb5rkr1u1foU4dqhQPBpi7Qk9R4/
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186963200000",
"number": "1003008137",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 BROADWAY",
"address_2": "SUITE 190",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981225395",
"telephone_number": "206-323-4040",
"fax_number": "206-324-0943"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 BROADWAY",
"address_2": "SUITE 190",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981225395",
"telephone_number": "206-323-4040",
"fax_number": "206-324-0943"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREDEEN",
"first_name": "GRACE",
"name_prefix": "Miss",
"credential": "CO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-13",
"last_updated": "2007-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "222Z00000X",
"taxonomy_group": "",
"desc": "Orthotist",
"state": "WA",
"license": "OI00000178",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9036963",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.