Active NPI
Megan Black, OTR/L
- Occupational Therapist
- Puyallup, WA
National Provider Identifier
1104392109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 60875784
- Practice address
- 40 29TH St NE
Puyallup, WA 98372 - Phone
- (518) 420-2736
- NPI assigned
- Oct 17, 2018
- Sex
- Female
- 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 | 60875784 | WA | Primary |
Addresses
Primary practice location
40 29TH St NE
Puyallup, WA 98372
Mailing address
5016 Fairwood Blvd NE Apt 6
Tacoma, WA 98422-2170
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 |
|---|---|---|---|
| 60875784 | WA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539734400000",
"number": "1104392109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5016 FAIRWOOD BLVD NE APT 6",
"city": "TACOMA",
"state": "WA",
"postal_code": "984222170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 29TH ST NE",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "98372",
"telephone_number": "518-420-2736"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "MEGAN",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-17",
"last_updated": "2018-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WA",
"license": "60875784",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Puyallup, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.