Individual provider Active NPI

Patricia Soderlund Holladay, OTR

  • Occupational Therapist
  • Snoqualmie, WA
National Provider Identifier
1255675302
Registry record updated Nov 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
00001193 Issued in WA
Practice address
8001 Silva Ave SE
Snoqualmie, WA 98065
Phone
(425) 831-8000
NPI assigned
Nov 15, 2012
Last updated
Nov 15, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 00001193 WA Primary

Addresses

Primary practice location

8001 Silva Ave SE
Snoqualmie, WA 98065

Mailing address

19425 SE 21St St
Sammamish, WA 98075-7466
Phone (425) 831-4074

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
00001193WAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Snoqualmie Valley School District Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352937600000",
    "number": "1255675302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19425 SE 21ST ST",
            "city": "SAMMAMISH",
            "state": "WA",
            "postal_code": "980757466",
            "telephone_number": "425-831-4074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8001 SILVA AVE SE",
            "city": "SNOQUALMIE",
            "state": "WA",
            "postal_code": "98065",
            "telephone_number": "425-831-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLADAY",
        "first_name": "PATRICIA",
        "middle_name": "SODERLUND",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-15",
        "last_updated": "2012-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "00001193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snoqualmie, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.