Individual provider Active NPI

Kathleen Marie Nielsen, OTR/L, CHT

  • Hand Occupational Therapist
  • Bellevue, WA
National Provider Identifier
1245548338
Registry record updated Aug 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
OT00003441 Issued in WA
Practice address
1810 116TH Ave NE
Suite D-4
Bellevue, WA 98004-3058
Phone
(425) 283-5230
Fax
(425) 283-5236
NPI assigned
Sep 22, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 00003441 WA
Hand Occupational Therapist 225XH1200X OT00003441 WA Primary

Addresses

Primary practice location

1810 116TH Ave NE
Suite D-4
Bellevue, WA 98004-3058

Mailing address

12911 120TH Ave NE Ste H220
Kirkland, WA 98034-3064
Phone (425) 823-4224

Other practice location 1

12911 120th Ave NE Ste H220
Kirkland, WA 98034-3064
Phone (425) 823-4224

Other identifiers 1

IdentifierTypeStateIssuer
2065052MedicaidWA

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

LicenseStateTypeSpecialty
00003441WAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons Inc P S Occupational Therapist CurrentSince Aug 15, 2016 Accepting new patients
Proliance Surgeons Inc P S CurrentSince Aug 15, 2016 Accepting new patients
Proliance Surgeons Inc P S Current Accepting new patients

Locations

1810 116th Ave NE
Ste D4
Bellevue, WA 98004
Phone (425) 283-5230

12911 120th Ave NE
Ste H220
Kirkland, WA 98034
Phone (425) 216-7075

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1285113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1245548338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12911 120TH AVE NE STE H220",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343064",
            "telephone_number": "425-823-4224",
            "fax_number": "425-820-8975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 116TH AVE NE",
            "address_2": "SUITE D-4",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043058",
            "telephone_number": "425-283-5230",
            "fax_number": "425-283-5236"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12911 120th Ave NE Ste H220",
            "address_purpose": "LOCATION",
            "city": "Kirkland",
            "state": "WA",
            "postal_code": "980343064",
            "country_code": "US",
            "telephone_number": "425-823-4224",
            "fax_number": "425-820-8975",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "KATHLEEN",
        "middle_name": "MARIE",
        "credential": "OTR/L, CHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-22",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "00003441",
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "WA",
            "license": "OT00003441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2065052",
            "state": "WA"
        }
    ],
    "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 Aug 18, 2022; 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.