Individual provider Active NPI

Patricia Ann Halgren

  • Occupational Therapy Assistant
  • Bainbridge Island, WA
National Provider Identifier
1174720239
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OC00001136 Issued in WA
Practice address
835 Madison Ave N
Bainbridge Island, WA 98110-1700
Phone
(206) 842-4765
NPI assigned
Jun 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OC00001136 WA Primary

Addresses

Primary practice location

835 Madison Ave N
Bainbridge Island, WA 98110-1700

Mailing address

8484 NE County Park Rd
Bainbridge Island, WA 98110-3071
Phone (206) 780-3887

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

LicenseStateTypeSpecialty
OC00001136WAMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174720239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8484 NE COUNTY PARK RD",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981103071",
            "telephone_number": "206-780-3887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 MADISON AVE N",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981101700",
            "telephone_number": "206-842-4765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALGREN",
        "first_name": "PATRICIA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WA",
            "license": "OC00001136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bainbridge Island, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.