Individual provider Active NPI

Carolyn Leigh Needham, COTA/L

  • Occupational Therapy Assistant
  • University Place, WA
National Provider Identifier
1194531509
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OC61105992 Issued in WA
Practice address
3717 Grandview Dr W
University Place, WA 98466-2138
Phone
(253) 566-5600
NPI assigned
Dec 10, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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 OC61105992 WA Primary

Addresses

Primary practice location

3717 Grandview Dr W
University Place, WA 98466-2138

Mailing address

3511 S 263Rd St
Kent, WA 98032-7041
Phone (206) 384-2206

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
OC61105992WAMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1733788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1194531509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3511 S 263RD ST",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980327041",
            "telephone_number": "206-384-2206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3717 GRANDVIEW DR W",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984662138",
            "telephone_number": "253-566-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEEDHAM",
        "first_name": "CAROLYN",
        "middle_name": "LEIGH",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-10",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WA",
            "license": "OC61105992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in University Place, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; 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.