Individual provider Active NPI

Michelle Williams

  • Occupational Therapy Assistant
  • Newcastle, WA
National Provider Identifier
1194176693
Registry record updated Jun 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OC 60539296 Issued in WA
Practice address
7454 Newcastle Golf Club Rd
Newcastle, WA 98059-9176
Phone
(425) 453-1508
Fax
(847) 881-9670
NPI assigned
Jun 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2016

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 OC 60539296 WA Primary

Addresses

Primary practice location

7454 Newcastle Golf Club Rd
Newcastle, WA 98059-9176

Mailing address

21648 SE 281St St
Maple Valley, WA 98038-3316
Phone (206) 795-4799

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
OC 60539296WAMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Select Rehabilitation, LLC Occupational Therapy Assistant Past Accepting new patients

Organizations & group practices 1

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": "1466899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466899200000",
    "number": "1194176693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21648 SE 281ST ST",
            "city": "MAPLE VALLEY",
            "state": "WA",
            "postal_code": "980383316",
            "telephone_number": "206-795-4799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7454 NEWCASTLE GOLF CLUB RD",
            "city": "NEWCASTLE",
            "state": "WA",
            "postal_code": "980599176",
            "telephone_number": "425-453-1508",
            "fax_number": "847-881-9670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-26",
        "last_updated": "2016-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WA",
            "license": "OC 60539296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newcastle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.