Active NPI
Colleen Anderson, OTR/L
- Occupational Therapist
- Vancouver, WA
National Provider Identifier
1124440656
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT00004446
- Practice address
- 801 SE Park Crest Ave
Vancouver, WA 98683-1300 - Phone
- (360) 260-2200
- Fax
- (360) 713-0967
- NPI assigned
- Jan 17, 2014
- 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 | OT00004446 | WA | Primary |
Addresses
Primary practice location
801 SE Park Crest Ave
Vancouver, WA 98683-1300
Mailing address
801 SE Park Crest Ave
Vancouver, WA 98683-1300
Phone (360) 260-2200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4112819 | Medicaid | WA |
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 |
|---|---|---|---|
| OT00004446 | WA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1389916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389916800000",
"number": "1124440656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "801 SE PARK CREST AVE",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986831300",
"telephone_number": "360-260-2200",
"fax_number": "360-713-0967"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 SE PARK CREST AVE",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986831300",
"telephone_number": "360-260-2200",
"fax_number": "360-713-0967"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "COLLEEN",
"name_prefix": "Mrs.",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-01-17",
"last_updated": "2014-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WA",
"license": "OT00004446",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4112819",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.