Jeannette Wake, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT00002288 Issued in WA

Practice address

20310 19TH Ave NE
Shoreline, WA 98155-1261

Phone

(206) 367-5853

NPI assigned

Feb 22, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Child & Family Mental Health Services LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Shoreline, WA
  • NPI 1689242968
  NPD (past)
• PT & OT of Washington, LLC

  dba Pediatric PT & OT Services

  • Clinic/Center
  • Shoreline, WA
  • NPI 1356415756
  NPD (past)

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366577058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4034 41ST AVE SW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981163818",
            "telephone_number": "206-367-5853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20310 19TH AVE NE",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981551261",
            "telephone_number": "206-367-5853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAKE",
        "first_name": "JEANNETTE",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT00002288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Vo
• Kathleen McKeegan Volkman, M.D.
• Edwin D Vyhmeister, MD
• Susan M. Wadden, E.A.M.P.
• Daniel Waddingham, PA-C
• Walgreen Co (Walgreens #03788)
• Walgreen Co (Walgreens #09373)
• Walgreen Co (Walgreens #04759)
• Walgreens
• Sofia Wall

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.