Individual provider Active NPI

Sharon L Moore

  • Occupational Therapist
  • Everett, WA
National Provider Identifier
1053657981
Registry record updated Dec 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT00003257 Issued in WA
Practice address
9600 Holly Dr
Everett, WA 98204-2607
Phone
(425) 366-2500
NPI assigned
Dec 20, 2012
Last updated
Dec 20, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2012

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 OT00003257 WA Primary

Addresses

Primary practice location

9600 Holly Dr
Everett, WA 98204-2607

Mailing address

1019 214TH PL SW
Lynnwood, WA 98036-8620
Phone (425) 778-1785

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

LicenseStateTypeSpecialty
OT00003257WAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1355961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355961600000",
    "number": "1053657981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 214TH PL SW",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980368620",
            "telephone_number": "425-778-1785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9600 HOLLY DR",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982042607",
            "telephone_number": "425-366-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "SHARON",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-20",
        "last_updated": "2012-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT00003257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2012; 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.