Susan Lynette Burgess, OCCUPATIONAL THERAPI

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT00001922 Issued in WA

Practice address

410 Providence Lane NE
Olympia, WA 98506

Phone

(360) 493-4995

Fax

(360) 493-4470

NPI assigned

Aug 14, 2012

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

Other names 1

• Miss Susan Lynette Henson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1344902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344902400000",
    "number": "1386991990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 PROVIDENCE LANE NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "98506",
            "telephone_number": "360-493-4995",
            "fax_number": "360-493-4470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 PROVIDENCE LANE NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "98506",
            "telephone_number": "360-493-4995",
            "fax_number": "360-493-4470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGESS",
        "first_name": "SUSAN",
        "middle_name": "LYNETTE",
        "name_prefix": "Mrs.",
        "credential": "OCCUPATIONAL THERAPI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-14",
        "last_updated": "2012-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT00001922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "HENSON",
            "middle_name": "LYNETTE",
            "prefix": "MISS",
            "credential": "OCCUPATIONAL THERAPI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lori Louise Anderson Buono, CCC.CL.61522106
• Lana K Bur, MD
• Reed Ward Burbank, CRNA
• Caitlin Burelson, DMD
• Francine E Burg, OTR L, LMP
• Blair Michael Burggren, D.V.M.
• Melynda Burleson, LMP
• Marguerite Burnett
• Kathryn Mary Burrell, ARNP
• Kloe Jasmine Burrell

• All providers in Olympia, WA
• Occupational Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2012; 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.