NPIMap

Organization Active NPI

Pacific Handworks Inc., P.S.

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Bellevue, WA
National Provider Identifier
1255516092
Registry record updated Dec 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X
License
OT00002234 Issued in WA
Legal business name
PACIFIC HANDWORKS INC., P.S.
Practice address
2800 Northup Way
200
Bellevue, WA 98004-1440
Phone
(425) 827-5877
Fax
(425) 827-5843
NPI assigned
Dec 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2007

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

Authorized official

Name
Ms. Kalaivani Moodaly, OTR/LNPI 1588833776
Title
Occupational Hand Therapist
Phone
(425) 827-5877

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X OT00002234 WA Primary

Addresses

Primary practice location

2800 Northup Way
200
Bellevue, WA 98004-1440

Mailing address

2800 Northup Way
200
Bellevue, WA 98004-1440
Phone (425) 827-5877

Other identifiers 6

IdentifierTypeStateIssuer
9260MOOtherWAREGENCE
0133894OtherWALABOR AND INDUSTRIES
7253070OtherWAAETNA
8943431OtherWAL&I CRIME VICTIMS
8384760MedicaidWA
2082989OtherWAFIRST HEALTH

National Provider Directory

National Provider Directory
Tax ID family
Pacific Handworks Inc PS3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2800 Northup Way
Ste 200
Bellevue, WA 98004
Phone (425) 827-5877

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1198800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198800000000",
    "number": "1255516092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 NORTHUP WAY",
            "address_2": "200",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980041440",
            "telephone_number": "425-827-5877",
            "fax_number": "425-827-5843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 NORTHUP WAY",
            "address_2": "200",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980041440",
            "telephone_number": "425-827-5877",
            "fax_number": "425-827-5843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC HANDWORKS INC., P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-28",
        "last_updated": "2007-12-28",
        "status": "A",
        "authorized_official_last_name": "MOODALY",
        "authorized_official_first_name": "KALAIVANI",
        "authorized_official_title_or_position": "OCCUPATIONAL HAND THERAPIST",
        "authorized_official_telephone_number": "425-827-5877",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": "WA",
            "license": "OT00002234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "9260MO",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "0133894",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7253070",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I CRIME VICTIMS",
            "identifier": "8943431",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8384760",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "2082989",
            "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 Dec 28, 2007; 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.