Active NPI
Brooke Hagen
- Occupational Therapist
- Lakewood, WA
National Provider Identifier
1154021673
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT61394064
- Practice address
- 9307 Bridgeport Way SW
Lakewood, WA 98499-1570 - Phone
- (253) 201-1234
- NPI assigned
- Mar 3, 2023
- 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 | OT61394064 | WA | Primary |
Addresses
Primary practice location
9307 Bridgeport Way SW
Lakewood, WA 98499-1570
Mailing address
1070 McDonald Ave
Dupont, WA 98327-9755
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 |
|---|---|---|---|
| OT61394064 | WA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cole Sky Therapy PLLC | Occupational Therapist | Current | Accepting new patients |
| Sky Bridge Therapies LLC | Occupational Therapist | Past | Accepting new patients |
Locations
9307 Bridgeport Way SW
Tacoma, WA 98499
Phone (253) 201-1234
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 and National Provider Directory roles.
-
- Developmental Disabilities Clinic/Center
- Lakewood, WA
- NPI 1356855530
Occupational Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1677801600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677801600000",
"number": "1154021673",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1070 MCDONALD AVE",
"city": "DUPONT",
"state": "WA",
"postal_code": "983279755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9307 BRIDGEPORT WAY SW",
"city": "LAKEWOOD",
"state": "WA",
"postal_code": "984991570",
"telephone_number": "253-201-1234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAGEN",
"first_name": "BROOKE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-03",
"last_updated": "2023-03-03",
"certification_date": "2023-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WA",
"license": "OT61394064",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakewood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.