Active NPI
Anne Nissila Smith, COTA
- Occupational Therapy Assistant
- Kent, WA
National Provider Identifier
1336506724
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- OC 60445101
- Practice address
- 22017 100TH CT SE
Kent, WA 98031-2537 - Phone
- (360) 635-8582
- NPI assigned
- Jan 15, 2016
- 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 | OC 60445101 | WA | Primary |
Addresses
Primary practice location
22017 100TH CT SE
Kent, WA 98031-2537
Mailing address
22017 100TH CT SE
Kent, WA 98031-2537
Phone (360) 635-8582
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OC 60445101 | Other | WA | COTA LICENSE |
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 |
|---|---|---|---|
| OC 60445101 | WA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1452816000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452816000000",
"number": "1336506724",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22017 100TH CT SE",
"city": "KENT",
"state": "WA",
"postal_code": "980312537",
"telephone_number": "360-635-8582"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22017 100TH CT SE",
"city": "KENT",
"state": "WA",
"postal_code": "980312537",
"telephone_number": "360-635-8582"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "ANNE",
"middle_name": "NISSILA",
"credential": "COTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-01-15",
"last_updated": "2016-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "WA",
"license": "OC 60445101",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COTA LICENSE",
"identifier": "OC 60445101",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kent, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.