Individual provider Active NPI

Catherine Clarite Campo, P.T. ASSISTANT

  • Physical Therapy Assistant
  • Shoreline, WA
National Provider Identifier
1245569565
Registry record updated Mar 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
P160129470 Issued in WA
Practice address
1250 NE 145TH St
Shoreline, WA 98155-7134
Phone
(206) 957-8818
NPI assigned
Dec 15, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 005808 NY
Physical Therapy Assistant 225200000X P160129470 WA Primary

Addresses

Primary practice location

1250 NE 145TH St
Shoreline, WA 98155-7134

Mailing address

20318 Bothell Everett Hwy
A204
Bothell, WA 98012-7156
Phone (425) 949-5469

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
P160129470WAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1260835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332115200000",
    "number": "1245569565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20318 BOTHELL EVERETT HWY",
            "address_2": "A204",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980127156",
            "telephone_number": "425-949-5469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 NE 145TH ST",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981557134",
            "telephone_number": "206-957-8818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPO",
        "first_name": "CATHERINE",
        "middle_name": "CLARITE",
        "name_prefix": "Ms.",
        "credential": "P.T. ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-15",
        "last_updated": "2012-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "005808",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "P160129470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreline, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2012; 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.