Bonnie Keen

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

P1 60469533 Issued in WA

Practice address

927 E Fairhaven Ave
Burlington, WA 98233-1918

Phone

(360) 757-3311

NPI assigned

May 1, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Burlington-Edison School District

  • Local Education Agency (LEA)
  • Burlington, WA
  • NPI 1699866764
  NPD (past)

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

{
    "created_epoch": "1430438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430438400000",
    "number": "1306223029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "927 E FAIRHAVEN AVE",
            "city": "BURLINGTON",
            "state": "WA",
            "postal_code": "982331918",
            "telephone_number": "360-757-3311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 E FAIRHAVEN AVE",
            "city": "BURLINGTON",
            "state": "WA",
            "postal_code": "982331918",
            "telephone_number": "360-757-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEEN",
        "first_name": "BONNIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-01",
        "last_updated": "2015-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "P1 60469533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1016728",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angelia Shelita Jordan
• Joseph S Wald Enterprises Inc
• Joseph Wald OD Inc
• Trisha Kathleen Tremper Justice, COTA
• Kathleen a Stambaugh, DDS PS
• Keith a. Salvatori, DMD, P.C.
• Jodie Lynn Kercheval
• Daniel Kihangu
• Annika Lucia King
• Aniko G Kiss

• Physical Therapy Assistant in Burlington, WA
• Providers in Burlington, WA by specialty
• Physical Therapy Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2015; 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.