Crystal Gayle Phillips, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OC60606631 Issued in WA

Practice address

20063 State Route 410 E
Bonney Lake, WA 98391-8460

Phone

(253) 447-8562

NPI assigned

Jan 18, 2016

Last updated

Jan 18, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1453075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453075200000",
    "number": "1154788420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20063 STATE ROUTE 410 E",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983918460",
            "telephone_number": "253-447-8562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20063 STATE ROUTE 410 E",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983918460",
            "telephone_number": "253-447-8562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "CRYSTAL",
        "middle_name": "GAYLE",
        "name_prefix": "Miss",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-18",
        "last_updated": "2016-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WA",
            "license": "OC60606631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapy Assistant in Bonney Lake, WA
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• Occupational Therapy Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.