NPIMap

Individual provider Active NPI

Emily Wickert

  • Occupational Therapist
  • Vancouver, WA
National Provider Identifier
1386098259
Registry record updated Apr 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
266337 Issued in OR
Practice address
13115 NE 4TH St
Suite 100
Vancouver, WA 98684-5957
Phone
(360) 696-1070
NPI assigned
Apr 18, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 266337 OR Primary
Occupational Therapist 225X00000X 60644991 WA

Addresses

Primary practice location

13115 NE 4TH St
Suite 100
Vancouver, WA 98684-5957

Mailing address

13115 NE 4TH St
Suite 100
Vancouver, WA 98684-5957
Phone (360) 696-1070

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
60644991WAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon 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": "1460937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460937600000",
    "number": "1386098259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13115 NE 4TH ST",
            "address_2": "SUITE 100",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986845957",
            "telephone_number": "360-696-1070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13115 NE 4TH ST",
            "address_2": "SUITE 100",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986845957",
            "telephone_number": "360-696-1070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKERT",
        "first_name": "EMILY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-18",
        "last_updated": "2016-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OR",
            "license": "266337",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "60644991",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.

Verify at the official NPI Registry.