Nicole Joyce D Lasquete Bautista, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OC61253538 Issued in WA

Practice address

12033 SE 256TH St
Kent, WA 98030-6643

Phone

(253) 373-7030

NPI assigned

May 30, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1685404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1245923952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19021 EAGLE RIDGE DR E",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983914007",
            "telephone_number": "747-266-7823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12033 SE 256TH ST",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980306643",
            "telephone_number": "253-373-7030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "NICOLE",
        "middle_name": "JOYCE D LASQUETE",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-30",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WA",
            "license": "OC61253538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jean-Luke Bartlett
• Inna Barvinenko
• Sara Barbara Basil, SLP
• Robert Bruce Baucke, MD
• Lauren Elizabeth Bauer
• Jeffrey W Baxter, MA LMFT LMHC
• John G Beack, D.M.D.
• Imelda Dizon Beal, RN
• Christine D Bechtold Morse, PT
• Ryan Beck

• All providers in Kent, WA
• Occupational Therapy Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 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.