Active NPI
Danette K Sadle-Glass
- Pediatric Occupational Therapist
- Vancouver, WA
National Provider Identifier
1306664396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- OT61578241
- Practice address
- 2500 NE 65TH Ave
Vancouver, WA 98661-6812 - Phone
- (503) 970-0044
- NPI assigned
- Sep 30, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | OT61578241 | WA | Primary |
Addresses
Primary practice location
2500 NE 65TH Ave
Vancouver, WA 98661-6812
Mailing address
3540 SW Hume St
Portland, OR 97219-3758
Phone (503) 970-0044
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
| License | State | Type | Specialty |
|---|---|---|---|
| OT61578241 | WA | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1727654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727654400000",
"number": "1306664396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3540 SW HUME ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972193758",
"telephone_number": "503-970-0044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 NE 65TH AVE",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986616812",
"telephone_number": "503-970-0044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SADLE-GLASS",
"first_name": "DANETTE",
"middle_name": "K",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-09-30",
"last_updated": "2024-09-30",
"certification_date": "2024-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "WA",
"license": "OT61578241",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.