Individual provider Active NPI

Paula Vaerewyck, COTA/L

  • Occupational Therapy Assistant
  • Shelton, WA
National Provider Identifier
1326435579
Registry record updated Apr 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OC60239126 Issued in WA
Practice address
153 Johns CT
Shelton, WA 98584-8225
Phone
(360) 427-2575
NPI assigned
Apr 24, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OC60239126 WA Primary

Addresses

Primary practice location

153 Johns CT
Shelton, WA 98584-8225

Mailing address

153 Johns CT
Shelton, WA 98584-8225
Phone (360) 427-2575

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
OC60239126WAMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1429833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429833600000",
    "number": "1326435579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 JOHNS CT",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985848225",
            "telephone_number": "360-427-2575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 JOHNS CT",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985848225",
            "telephone_number": "360-427-2575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAEREWYCK",
        "first_name": "PAULA",
        "name_prefix": "Mrs.",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-24",
        "last_updated": "2015-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WA",
            "license": "OC60239126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2015; 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.