Individual provider Active NPI

Veronica Bullis, COTA

  • Occupational Therapy Assistant
  • Tacoma, WA
National Provider Identifier
1306239694
Registry record updated Mar 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OC 60506030 Issued in WA
Practice address
4632 143Rd St E
Tacoma, WA 98446-4134
Phone
(253) 301-7612
NPI assigned
Mar 10, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OC 60506030 WA Primary

Addresses

Primary practice location

4632 143Rd St E
Tacoma, WA 98446-4134

Mailing address

4632 143Rd St E
Tacoma, WA 98446-4134
Phone (253) 301-7612

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
OC 60506030WAMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1425945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425945600000",
    "number": "1306239694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4632 143RD ST E",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984464134",
            "telephone_number": "253-301-7612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4632 143RD ST E",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984464134",
            "telephone_number": "253-301-7612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLIS",
        "first_name": "VERONICA",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-10",
        "last_updated": "2015-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WA",
            "license": "OC 60506030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.