Jan Lyn Davis, OC00000206

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OC00000206 Issued in WA

Practice address

11104 NE 149TH St
Brush Prairie, WA 98606-9565

Phone

(360) 885-6700

Fax

(360) 885-6700

NPI assigned

Dec 13, 2012

Sex

Female

Sole proprietor

No

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.

• Battle Ground School District

  • Speech-Language Pathologist
  • Brush Prairie, WA
  • NPI 1215332580
  NPD (past)

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

{
    "created_epoch": "1355356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355356800000",
    "number": "1316283666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 200",
            "city": "BATTLE GROUND",
            "state": "WA",
            "postal_code": "986040200",
            "telephone_number": "360-885-6700",
            "fax_number": "360-885-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11104 NE 149TH ST",
            "city": "BRUSH PRAIRIE",
            "state": "WA",
            "postal_code": "986069565",
            "telephone_number": "360-885-6700",
            "fax_number": "360-885-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JAN",
        "middle_name": "LYN",
        "credential": "OC00000206",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-13",
        "last_updated": "2012-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WA",
            "license": "OC00000206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7989",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Eileen Chamberlain
• Janell S Chandler, DC
• Ingrid Larraine Colvard, LICSW
• Sarah Cook, MOTR/L
• Darcy Ann Davis
• Daybreak Youth Services
• Laura Brooke Deyo
• Dr Crystal Edison OD & Associates PLLC (Dr. Crystal Edison, O.D. & Associates)
• Miesha Jo Ebacher, CCC-SLP
• Crystal Marie Edison, O.D.

• Occupational Therapy Assistant in Brush Prairie, WA
• Providers in Brush Prairie, WA by specialty
• Occupational Therapy Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2012; 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.