Individual provider Active NPI

Marni L. Wilson, AAS

  • Physical Therapy Assistant
  • Seattle, WA
National Provider Identifier
1356547475
Registry record updated Jun 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
Practice address
4245 Roosevelt Way NE
Box 354745
Seattle, WA 98105-6008
Phone
(206) 598-2888
Fax
(206) 598-4484
NPI assigned
Jun 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X Primary

Addresses

Primary practice location

4245 Roosevelt Way NE
Box 354745
Seattle, WA 98105-6008

Mailing address

PO Box 24366
Seattle, WA 98124-0366
Phone (206) 598-0502

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
Credentials
Associate of Applied Science

Practice roles

OrganizationSpecialtyStatusNew patients
University of Washington Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401926400000",
    "number": "1356547475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24366",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981240366",
            "telephone_number": "206-598-0502",
            "fax_number": "206-598-0516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4245 ROOSEVELT WAY NE",
            "address_2": "BOX 354745",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981056008",
            "telephone_number": "206-598-2888",
            "fax_number": "206-598-4484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MARNI",
        "middle_name": "L.",
        "credential": "AAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-25",
        "last_updated": "2014-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2014; 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.