Individual provider Active NPI

Julie Randall, MSOT, OTR/L

  • Pediatric Occupational Therapist
  • Puyallup, WA
National Provider Identifier
1275986341
Registry record updated Jul 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT60664001 Issued in WA
Practice address
2929 5TH Ave NE
Suite a
Puyallup, WA 98372-6782
Phone
(253) 447-8216
Fax
(253) 447-8789
NPI assigned
Jul 13, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X OT60664001 WA Primary

Addresses

Primary practice location

2929 5TH Ave NE
Suite a
Puyallup, WA 98372-6782

Mailing address

8914 180TH Street CT E
Puyallup, WA 98375-6235
Phone (253) 875-7701

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
OT60664001WAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kids at Play Therapy, LLC 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1468368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468368000000",
    "number": "1275986341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8914 180TH STREET CT E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983756235",
            "telephone_number": "253-875-7701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2929 5TH AVE NE",
            "address_2": "SUITE A",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983726782",
            "telephone_number": "253-447-8216",
            "fax_number": "253-447-8789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "JULIE",
        "credential": "MSOT, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-13",
        "last_updated": "2016-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "WA",
            "license": "OT60664001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2016; 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.