Active NPI
Stacy Marie Earl, COTA/L
- Occupational Therapy Assistant
- Puyallup, WA
National Provider Identifier
1326384959
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- OC60313173
- Practice address
- 516 23Rd Ave SE
Puyallup, WA 98372-4659 - Phone
- (253) 845-6631
- NPI assigned
- Dec 31, 2012
- 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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | OC60313173 | WA | Primary |
Addresses
Primary practice location
516 23Rd Ave SE
Puyallup, WA 98372-4659
Mailing address
7902 192ND Ave E
Bonney Lake, WA 98391-8554
Phone (253) 720-2618
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 |
|---|---|---|---|
| OC60313173 | WA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1356912000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1356912000000",
"number": "1326384959",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7902 192ND AVE E",
"city": "BONNEY LAKE",
"state": "WA",
"postal_code": "983918554",
"telephone_number": "253-720-2618"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "516 23RD AVE SE",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983724659",
"telephone_number": "253-845-6631"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EARL",
"first_name": "STACY",
"middle_name": "MARIE",
"credential": "COTA/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-12-31",
"last_updated": "2012-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "WA",
"license": "OC60313173",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Puyallup, WA
- Sheridan A Ealey
- Ear Nose Throat & Plastic Surgery Associates of the South Sound PS
- Ear, Nose, Throat & Allergy Assoicaties PS
- Ear,Nose,Throat & Allergy Associates PS
- Ear,Nose,Throat &Allergy Associates PS
- Kevin Michael Earle, DC, CCEP
- Timothy P Earnest, M.D.
- Morgan Taylor Easley, LMT
- East Main Vision Clinic LLC
- Joel Aldor Eastman, RPH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 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.