Active NPI
Arianne Hedley, PTA
- Physical Therapy Assistant
- Marysville, WA
National Provider Identifier
1417455239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- P161553745
- Practice address
- 3719 88TH St NE Ste a
Marysville, WA 98270-7228 - Phone
- (360) 659-9621
- NPI assigned
- Jan 26, 2018
- Reactivated
- Aug 22, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | |||
| Physical Therapy Assistant | 225200000X | P161553745 | WA | Primary |
Addresses
Primary practice location
3719 88TH St NE Ste a
Marysville, WA 98270-7228
Mailing address
100 Universal City PLZ
Universal City, CA 91608-1002
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
| License | State | Type | Specialty |
|---|---|---|---|
| P161553745 | WA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724371200000",
"number": "1417455239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 UNIVERSAL CITY PLZ",
"city": "UNIVERSAL CITY",
"state": "CA",
"postal_code": "916081002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3719 88TH ST NE STE A",
"city": "MARYSVILLE",
"state": "WA",
"postal_code": "982707228",
"telephone_number": "360-659-9621"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEDLEY",
"first_name": "ARIANNE",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-26",
"last_updated": "2024-08-23",
"certification_date": "2024-08-23",
"deactivation_date": "2024-08-16",
"reactivation_date": "2024-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WA",
"license": "P161553745",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Marysville, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.