Marissa Johnson, MOT, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT60013976 Issued in WA

Practice address

17615 85TH Avenue CT E
Puyallup, WA 98375-1859

Phone

(253) 216-2589

NPI assigned

Jun 25, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Little Fin Therapies, LLC

  • Developmental Disabilities Clinic/Center
  • Puyallup, WA
  • NPI 1942811211
  NPD Authorized official

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

{
    "created_epoch": "1245888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1053549337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3620 68TH AVE W",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984665118",
            "telephone_number": "253-202-4246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17615 85TH AVENUE CT E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983751859",
            "telephone_number": "253-216-2589"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "32030 23rd Ave S",
            "address_purpose": "LOCATION",
            "city": "Federal Way",
            "state": "WA",
            "postal_code": "980036031",
            "country_code": "US",
            "telephone_number": "253-946-4852",
            "fax_number": "253-946-4862",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARISSA",
        "credential": "MOT, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-25",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT60013976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Johnson
• Jessica Lindsey Johnson, DPT
• Kelsey Kay Johnson, RDN, LMCHA, CEDS, CD
• Laura Dae Johnson, BS
• Lynda M Johnson, O.T.
• Mark J Johnson
• Mary Ellen Johnson, M.A.
• McKenna Anne Johnson, OTR/L
• Mikki Johnson
• Randall G Johnson, PT

• Occupational Therapist in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Occupational Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.