Active NPI
Connie Crum, OT
- Occupational Therapist
- Puyallup, WA
National Provider Identifier
1003832213
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT00001747
- Practice address
- 2904 Fourth Ave NE
Puyallup, WA 98372 - Phone
- (253) 848-4700
- NPI assigned
- Jul 14, 2006
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT00001747 | WA | Primary |
Addresses
Primary practice location
2904 Fourth Ave NE
Puyallup, WA 98372
Mailing address
PO Box 2170
Sumner, WA 98390-0480
Phone (253) 840-2313
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1747 | WA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297814400000",
"number": "1003832213",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2170",
"city": "SUMNER",
"state": "WA",
"postal_code": "983900480",
"telephone_number": "253-840-2313",
"fax_number": "253-840-6340"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2904 FOURTH AVE NE",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "98372",
"telephone_number": "253-848-4700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUM",
"first_name": "CONNIE",
"name_prefix": "Ms.",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-14",
"last_updated": "2011-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WA",
"license": "OT00001747",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Puyallup, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.