Kylie R Fordon, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT60842445 Issued in WA

Practice address

906 SE Everett Mall Way Ste 200
Everett, WA 98208-3743

Phone

(425) 353-5656

Fax

(425) 513-2807

NPI assigned

May 8, 2018

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

Locations

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.

• Childstrive

  • Developmental Disabilities Clinic/Center
  • Everett, WA
  • NPI 1205872280

  Occupational Therapist

  NPD

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

{
    "created_epoch": "1525737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577664000000",
    "number": "1326537069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 E CASINO RD STE A",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982082628",
            "telephone_number": "425-353-5656",
            "fax_number": "425-513-2807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 SE EVERETT MALL WAY STE 200",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982083743",
            "telephone_number": "425-353-5656",
            "fax_number": "425-513-2807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORDON",
        "first_name": "KYLIE",
        "middle_name": "R",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-08",
        "last_updated": "2019-12-30",
        "certification_date": "2019-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT60842445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2100391",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zachary J Forcade, MD
• Jaden Aries Forcher
• Charie Ford, LMP
• Danielle Ford
• Linda E Ford
• Dee Marie Foreman, RPH
• Forever Evolving Psychotherapy PLLC
• Nidia Marcela Forman, RDH, OMT
• Rebecca Louise Formosa, ARNP
• Chandler Davin Fornia, BA

• Occupational Therapist in Everett, WA
• Providers in Everett, WA by specialty
• Occupational Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2019; 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.