Kristin Dedge, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT60552139 Issued in WA

Practice address

20810 State Route 410 E
Bonney Lake, WA 98391-6301

Phone

(253) 447-8562

NPI assigned

Jul 14, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Amanda Saliba Pediatric Occupational Therapy Services

  • Occupational Therapist
  • Bonney Lake, WA
  • NPI 1639518400
  NPD (past)

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

{
    "created_epoch": "1468454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620000000000",
    "number": "1104279199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20810 STATE ROUTE 410 E",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983916301",
            "telephone_number": "253-447-8562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20810 STATE ROUTE 410 E",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983916301",
            "telephone_number": "253-447-8562"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "34616 11th Pl S Ste 1",
            "address_purpose": "LOCATION",
            "city": "Federal Way",
            "state": "WA",
            "postal_code": "980038705",
            "country_code": "US",
            "telephone_number": "253-447-8216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEDGE",
        "first_name": "KRISTIN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-14",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT60552139",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Hurtado Dammen, PA-C
• Ivy Dang, PHARMD
• Dani Danley, CPC1178, LH61165683
• Barbara Davidson
• Andressa Duarte De Meneses, LMT
• Susan Jayne Delmonte
• William Demonte, PSY.D.
• Dental Health Group
• Jamin Kristan Devaney, LMT
• Kiersti Devaney, ARNP

• Occupational Therapist in Bonney Lake, WA
• Providers in Bonney Lake, WA by specialty
• Occupational Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2021; 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.