Individual provider Active NPI

Mary Charlene Guardia, OTR/L,CHT

  • Hand Occupational Therapist
  • Gig Harbor, WA
National Provider Identifier
1033128236
Registry record updated Dec 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
00002991 Issued in WA
Practice address
2921 78TH Avenue CT NW
Gig Harbor, WA 98335-6498
Phone
(253) 363-3758
NPI assigned
Aug 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational Therapist 225XH1200X 00002991 WA Primary

Addresses

Primary practice location

2921 78TH Avenue CT NW
Gig Harbor, WA 98335-6498

Mailing address

5401 32ND Ave NW
Ste 104
Gig Harbor, WA 98335-6308
Phone (253) 363-3758

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120404000688 WA Practitioner - Occupational Therapist in Private Practice 4284894940 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5401 32ND Ave
Suite 104
Gig Harbor, WA 98335-6308
Phone (253) 363-3758

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00002991WAMDHand Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Bridge Occupational Therapy & Upper Extremity Rehabilitation LLC CurrentSince Oct 1, 2015 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Dec 1, 2014 Accepting new patients
The Bridge Occupational Therapy & Upper Extremity Rehabilitation LLC CurrentSince Jun 15, 2015 Accepting new patients
Multicare Health System CurrentSince Dec 1, 2014 Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

5401 32nd Ave
Ste 104
Gig Harbor, WA 98335
Phone (252) 363-3758

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

Organizations & group practices 5

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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480896000000",
    "number": "1033128236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 32ND AVE NW",
            "address_2": "STE 104",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983356308",
            "telephone_number": "253-363-3758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2921 78TH AVENUE CT NW",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983356498",
            "telephone_number": "253-363-3758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUARDIA",
        "first_name": "MARY",
        "middle_name": "CHARLENE",
        "name_prefix": "Mrs.",
        "credential": "OTR/L,CHT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2016-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "WA",
            "license": "00002991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gig Harbor, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.