Active NPI
Julie Ann Ellenberger, OTR/L
- Hand Occupational Therapist
- Issaquah, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hand Occupational Therapist
- License
- OT60302480
- Practice address
- 510 8TH Ave NE Ste 340
Issaquah, WA 98029-5449 - Phone
- (425) 313-3055
- Fax
- (425) 313-3051
- NPI assigned
- Jul 24, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT60302480 | WA | |
| Hand Occupational Therapist | 225XH1200X | OT60302480 | WA | Primary |
Addresses
Primary practice location
510 8TH Ave NE Ste 340
Issaquah, WA 98029-5449
Mailing address
510 8TH Ave NE Ste 320
Issaquah, WA 98029-5436
Phone (425) 313-3055
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2105652 | Medicaid | WA |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT60302480 | WA | MD | Hand Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Proliance Surgeons Inc., P.S. | Occupational Therapist | Current | Accepting new patients |
| Proliance Surgeons Inc P S | Current | Accepting new patients | |
| Proliance Surgeons Inc P S | Current | Accepting new patients |
Locations
1200 112th Ave NE
Ste C260
Bellevue, WA 98004
Phone (425) 313-3055
510 8th Ave NE
Ste 340
Issaquah, WA 98029
Phone (425) 313-3051
510 8th Ave NE
Ste 320
Issaquah, WA 98029
805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Proliance Surgeons Orthopedic Specialists of Seattle
- Orthopaedic Surgery Physician
- Seattle, WA
- NPI 1023170313
-
dba Proliance Orthopedic Associates
- Orthopaedic Surgery Physician
- Renton, WA
- NPI 1235091463
-
dba Proliance Sports Therapy and Rehab of Issaquah
- Physical Therapist
- Issaquah, WA
- NPI 1083752042
Occupational Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675296000000",
"number": "1215283502",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "510 8TH AVE NE STE 320",
"city": "ISSAQUAH",
"state": "WA",
"postal_code": "980295436",
"telephone_number": "425-313-3055",
"fax_number": "425-313-3051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "510 8TH AVE NE STE 340",
"city": "ISSAQUAH",
"state": "WA",
"postal_code": "980295449",
"telephone_number": "425-313-3055",
"fax_number": "425-313-3051"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLENBERGER",
"first_name": "JULIE",
"middle_name": "ANN",
"name_prefix": "Miss",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-24",
"last_updated": "2023-02-02",
"certification_date": "2023-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WA",
"license": "OT60302480",
"primary": false
},
{
"code": "225XH1200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Hand",
"state": "WA",
"license": "OT60302480",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2105652",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Issaquah, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.