Active NPI
Randall Dean
- Occupational Therapist
- Naches, WA
National Provider Identifier
1104379650
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT60663306
- Practice address
- 320 E Gleed Rd
Naches, WA 98937-9626 - Phone
- (509) 952-2860
- NPI assigned
- Aug 2, 2016
- Sex
- Male
- Sole proprietor
- No
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 | OT60663306 | WA | Primary |
Addresses
Primary practice location
320 E Gleed Rd
Naches, WA 98937-9626
Mailing address
2811 Tieton Dr
Yakima, WA 98902-3761
Phone (509) 574-5963
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 |
|---|---|---|---|
| OT60663306 | WA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470096000000",
"number": "1104379650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2811 TIETON DR",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989023761",
"telephone_number": "509-574-5963"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "320 E GLEED RD",
"city": "NACHES",
"state": "WA",
"postal_code": "989379626",
"telephone_number": "509-952-2860"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEAN",
"first_name": "RANDALL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-08-02",
"last_updated": "2016-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WA",
"license": "OT60663306",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Naches, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.