Individual provider Active NPI

Kanyarak Yanawuth, MSOT, OTR

  • Occupational Therapist
  • Bellevue, WA
National Provider Identifier
1205638715
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
13037 NE Bel Red Rd Ste 102
Bellevue, WA 98005-2618
Phone
(425) 502-9440
NPI assigned
Mar 25, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X WA
Occupational Therapist 225X00000X WA Primary

Addresses

Primary practice location

13037 NE Bel Red Rd Ste 102
Bellevue, WA 98005-2618

Mailing address

123 112TH Ave NE Apt 411
Bellevue, WA 98004-6493
Phone (314) 898-7866

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

NPI Registry JSON

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

{
    "created_epoch": "1742860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1205638715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 112TH AVE NE APT 411",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980046493",
            "telephone_number": "314-898-7866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13037 NE BEL RED RD STE 102",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980052618",
            "telephone_number": "425-502-9440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANAWUTH",
        "first_name": "KANYARAK",
        "credential": "MSOT, OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-25",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2025; 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.