Active NPI
Kerwin John Doughton, OTR/L
- Occupational Therapist
- Lakewood, WA
National Provider Identifier
1053649012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT 00003047
- Practice address
- 9601 Steilacoom Blvd SW
Lakewood, WA 98498-7212 - Phone
- (253) 756-2800
- NPI assigned
- Dec 2, 2009
- Sex
- Male
- Sole proprietor
- Yes
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 | OT 00003047 | WA | Primary |
Addresses
Primary practice location
9601 Steilacoom Blvd SW
Lakewood, WA 98498-7212
Mailing address
4701 73Rd Avenue CT W
University Place, WA 98466-4244
Phone (253) 565-7222
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 |
|---|---|---|---|
| OT 00003047 | WA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1259712000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1259712000000",
"number": "1053649012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4701 73RD AVENUE CT W",
"city": "UNIVERSITY PLACE",
"state": "WA",
"postal_code": "984664244",
"telephone_number": "253-565-7222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9601 STEILACOOM BLVD SW",
"city": "LAKEWOOD",
"state": "WA",
"postal_code": "984987212",
"telephone_number": "253-756-2800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUGHTON",
"first_name": "KERWIN",
"middle_name": "JOHN",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-12-02",
"last_updated": "2009-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WA",
"license": "OT 00003047",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakewood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.