Individual provider Active NPI

Pamela Jo Merrill, COTA

  • Occupational Therapy Assistant
  • Oak Harbor, WA
National Provider Identifier
1417291162
Registry record updated Nov 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OC Issued in WA
Practice address
330 E Crescent Harbor Rd
Oak Harbor, WA 98277-9142
Phone
(360) 279-5694
NPI assigned
Nov 19, 2012
Last updated
Nov 19, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2012

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 OC WA Primary

Addresses

Primary practice location

330 E Crescent Harbor Rd
Oak Harbor, WA 98277-9142

Mailing address

4379 Northgate Dr
Oak Harbor, WA 98277-9581
Phone (360) 279-2413

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
OCWAMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1353283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353283200000",
    "number": "1417291162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4379 NORTHGATE DR",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982779581",
            "telephone_number": "360-279-2413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 E CRESCENT HARBOR RD",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982779142",
            "telephone_number": "360-279-5694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRILL",
        "first_name": "PAMELA",
        "middle_name": "JO",
        "name_prefix": "Ms.",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-19",
        "last_updated": "2012-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WA",
            "license": "OC",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Harbor, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.