Individual provider Active NPI

Arnold Agraviador

  • Occupational Therapy Assistant
  • Bellevue, WA
National Provider Identifier
1215716568
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OC61360597 Issued in WA
Practice address
933 111TH Ave NE
Bellevue, WA 98004-4486
Phone
(425) 504-8821
NPI assigned
Sep 26, 2023
Last updated
Sep 26, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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 OC61360597 WA Primary

Addresses

Primary practice location

933 111TH Ave NE
Bellevue, WA 98004-4486

Mailing address

2580 118TH Ave SE Apt 2-104
Bellevue, WA 98005-8161
Phone (310) 999-9193

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
OC61360597WAMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1695686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1215716568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2580 118TH AVE SE APT 2-104",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980058161",
            "telephone_number": "310-999-9193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 111TH AVE NE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044486",
            "telephone_number": "425-504-8821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGRAVIADOR",
        "first_name": "ARNOLD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-26",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WA",
            "license": "OC61360597",
            "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 Sep 26, 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.

Verify at the official NPI Registry.