Individual provider Active NPI

Devin Lee Jacques, OTR/L

  • Occupational Therapist
  • Wenatchee, WA
National Provider Identifier
1114291663
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT60823109 Issued in WA
Practice address
1000B N Miller St
Wenatchee, WA 98801-1512
Phone
(509) 663-8711
NPI assigned
Mar 1, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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 OT60823109 WA Primary

Addresses

Primary practice location

1000B N Miller St
Wenatchee, WA 98801-1512

Mailing address

820 N Chelan Ave
Wenatchee, WA 98801-2028
Phone (509) 663-8711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180403000935 WA Practitioner - Occupational Therapist in Private Practice 9638431695 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Washington Health Services AssociationGroup PAC ID 4880504596, 708 clinicians

Practice addresses (Care Compare)

1201 S Miller St
Wenatchee, WA 98801-3201
Phone (509) 662-2208

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Highline Physical Therapy Group Occupational Therapist CurrentSince Apr 4, 2020 Accepting new patients
Wenatchee Valley Hospital CurrentSince May 1, 2020 Accepting new patients
Wenatchee Valley Hospital Current Accepting new patients
Central Washington Health Services Association CurrentSince May 1, 2020 Accepting new patients
Central Washington Health Services Association Current Accepting new patients
Highline Physical Therapy Group Occupational Therapist CurrentSince Apr 4, 2020 Accepting new patients
Ozark Tri-County Health Care Consortium Past Accepting new patients

Locations

16259 Sylvester Rd SW
Burien, WA 98166
Phone (206) 241-5400

1010 S 336th St
Ste 112
Federal Way, WA 98003
Phone (253) 661-0041

17 S Western Ave
Tonasket, WA 98855
Phone (509) 486-2174

13050 Military Rd S
Tukwila, WA 98168
Phone (206) 248-3080

933 Red Apple Rd
Wenatchee, WA 98801
Phone (509) 655-6125

1000 N Miller St
Ste B
Wenatchee, WA 98801

820 N Chelan Ave
Wenatchee, WA 98801
Phone (509) 863-4868

1201 S Miller St
Wenatchee, WA 98801
Phone (509) 662-2208

1000 N Miller St
#B
Wenatchee, WA 98801
Phone (509) 436-4601

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1330560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1114291663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 N CHELAN AVE",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012028",
            "telephone_number": "509-663-8711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000B N MILLER ST",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988011512",
            "telephone_number": "509-663-8711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACQUES",
        "first_name": "DEVIN",
        "middle_name": "LEE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-01",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT60823109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wenatchee, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.