Individual provider Active NPI

Stacy Lee Oppliger Simoneaux, OTR/L, MBA-HA

  • Occupational Therapist
  • Tukwila, WA
National Provider Identifier
1013724558
Registry record updated May 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT61284025 Issued in WA
Practice address
6400 Southcenter Blvd
Tukwila, WA 98188-2547
Phone
(206) 901-2000
Fax
(206) 901-2010
NPI assigned
Dec 17, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT61284025 WA Primary

Addresses

Primary practice location

6400 Southcenter Blvd
Tukwila, WA 98188-2547

Mailing address

6400 Southcenter Blvd
Tukwila, WA 98188-2547
Phone (206) 901-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250611001605 WA Practitioner - Occupational Therapist in Private Practice 2163932823 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT61284025WAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sound CurrentSince Apr 3, 2025 Accepting new patients

Locations

13555 NE Bel Red Rd
Ste 228
Bellevue, WA 98005
Phone (206) 887-7147

1600 E Olive St
Seattle, WA 98122
Phone (206) 302-2800

6400 Southcenter Blvd
Tukwila, WA 98188
Phone (206) 444-3600

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1734393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748563200000",
    "number": "1013724558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 SOUTHCENTER BLVD",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981882547",
            "telephone_number": "206-901-2000",
            "fax_number": "206-901-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 SOUTHCENTER BLVD",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981882547",
            "telephone_number": "206-901-2000",
            "fax_number": "206-901-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONEAUX",
        "first_name": "STACY",
        "middle_name": "LEE OPPLIGER",
        "credential": "OTR/L, MBA-HA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-17",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT61284025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tukwila, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.