Active NPI
Samantha Eden Riley, PTA
- Physical Therapy Assistant
- Woodland, WA
National Provider Identifier
1346066537
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- P161406939
- Practice address
- 800 2ND St
Woodland, WA 98674-8349 - Phone
- (360) 841-2700
- NPI assigned
- Dec 3, 2024
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | P161406939 | WA | Primary |
Addresses
Primary practice location
800 2ND St
Woodland, WA 98674-8349
Mailing address
8904 NE 30TH Ave
Vancouver, WA 98665-9502
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 |
|---|---|---|---|
| P161406939 | WA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1733184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733184000000",
"number": "1346066537",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8904 NE 30TH AVE",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986659502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 2ND ST",
"city": "WOODLAND",
"state": "WA",
"postal_code": "986748349",
"telephone_number": "360-841-2700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RILEY",
"first_name": "SAMANTHA",
"middle_name": "EDEN",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-12-03",
"last_updated": "2024-12-03",
"certification_date": "2024-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WA",
"license": "P161406939",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodland, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.