Individual provider Active NPI

Alyssa Sue Larson

  • Occupational Therapist
  • Liberty Lake, WA
National Provider Identifier
1144170150
Registry record updated Jan 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT70086610 Issued in WA
Practice address
21651 E Country Vista Dr
Liberty Lake, WA 99019-7708
Phone
(208) 966-4176
NPI assigned
Jan 29, 2026
Last updated
Jan 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2026

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 OT70086610 WA Primary

Addresses

Primary practice location

21651 E Country Vista Dr
Liberty Lake, WA 99019-7708

Mailing address

PO Box 1180
Hayden, ID 83835-1180
Phone (208) 966-4176

Other practice location 1

3009 S Grand Blvd
Spokane, WA 99203-2559
Phone (208) 966-4176

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260305004058 WA Practitioner - Occupational Therapist in Private Practice 4880176064 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake City Physical Therapy P aGroup PAC ID 3678465234, 13 clinicians

Practice addresses (Care Compare)

21651 E County Vista Dr
Suite E
Liberty Lake, WA 99019-7710
Phone (509) 822-7834

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT70086610WAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lake City Physical Therapy P a Occupational Therapist CurrentSince Feb 3, 2026 Accepting new patients
Lake City Physical Therapy P a Occupational Therapist PastSince Aug 17, 2025 Accepting new patients

Locations

21651 E Country Vista Dr
Liberty Lake, WA 99019
Phone (509) 598-9402

3009 S Grand Blvd
Spokane, WA 99203
Phone (208) 966-4176

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1769644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769644800000",
    "number": "1144170150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1180",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838351180",
            "telephone_number": "208-966-4176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21651 E COUNTRY VISTA DR",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990197708",
            "telephone_number": "208-966-4176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3009 S Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992032559",
            "country_code": "US",
            "telephone_number": "208-966-4176",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARSON",
        "first_name": "ALYSSA",
        "middle_name": "SUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-29",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT70086610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty Lake, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2026; 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.