Individual provider Active NPI

Danette K Sadle-Glass

  • Pediatric Occupational Therapist
  • Vancouver, WA
National Provider Identifier
1306664396
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT61578241 Issued in WA
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

Updated by the provider on Sep 30, 2024

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 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

LicenseStateTypeSpecialty
OT61578241WAMDPediatric 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.

Verify at the official NPI Registry.