Individual provider Active NPI

Vanessa Lynn Omer, PTA

  • Physical Therapy Assistant
  • Bellingham, WA
National Provider Identifier
1316784531
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
61309305 Issued in WA
Practice address
459 W Stuart Rd
Bellingham, WA 98226-1204
Phone
(360) 671-5872
NPI assigned
Jul 15, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 61309305 WA Primary

Addresses

Primary practice location

459 W Stuart Rd
Bellingham, WA 98226-1204

Mailing address

1495 Harksell Rd
Ferndale, WA 98248-9752
Phone (360) 746-4014

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
61309305WAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1721001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1316784531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1495 HARKSELL RD",
            "city": "FERNDALE",
            "state": "WA",
            "postal_code": "982489752",
            "telephone_number": "360-746-4014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "459 W STUART RD",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982261204",
            "telephone_number": "360-671-5872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMER",
        "first_name": "VANESSA",
        "middle_name": "LYNN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-15",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "61309305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.