Individual provider Active NPI

Marla Jeanine Ellingsen-Totah, OTR

  • Occupational Therapist
  • Shoreline, WA
National Provider Identifier
1174794044
Registry record updated Mar 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
00004617 Issued in WA
Practice address
20310 19TH Ave NE
Shoreline, WA 98155-1261
Phone
(206) 367-5853
NPI assigned
Mar 18, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2008

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 00004617 WA Primary

Addresses

Primary practice location

20310 19TH Ave NE
Shoreline, WA 98155-1261

Mailing address

6533 24TH Ave NW
Apartment a
Seattle, WA 98117-5846
Phone (206) 453-3464

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
00004617WAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Child & Family Mental Health Services LLC PastSince Jun 22, 2021 Accepting new patients
PT & OT of Washington, LLC Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1205798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205798400000",
    "number": "1174794044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6533 24TH AVE NW",
            "address_2": "APARTMENT A",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981175846",
            "telephone_number": "206-453-3464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20310 19TH AVE NE",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981551261",
            "telephone_number": "206-367-5853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLINGSEN-TOTAH",
        "first_name": "MARLA",
        "middle_name": "JEANINE",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-18",
        "last_updated": "2008-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "00004617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreline, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; 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.