Individual provider Active NPI

Sunoma Codispoti, COTA/L

  • Occupational Therapy Assistant
  • Shoreline, WA
National Provider Identifier
1396130373
Registry record updated Apr 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OC60539249 Issued in WA
Practice address
19235 15TH Ave NW
Shoreline, WA 98177-2725
Phone
(206) 546-2666
NPI assigned
Apr 6, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OC60539249 WA Primary

Addresses

Primary practice location

19235 15TH Ave NW
Shoreline, WA 98177-2725

Mailing address

25117 SW Parkway Ave
Ste D
Wilsonville, OR 97070-9697

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

LicenseStateTypeSpecialty
OC60539249WAMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1428278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428278400000",
    "number": "1396130373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25117 SW PARKWAY AVE",
            "address_2": "STE D",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970709697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19235 15TH AVE NW",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981772725",
            "telephone_number": "206-546-2666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CODISPOTI",
        "first_name": "SUNOMA",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-06",
        "last_updated": "2015-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WA",
            "license": "OC60539249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreline, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2015; 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.