Individual provider Active NPI

Arianne Hedley, PTA

  • Physical Therapy Assistant
  • Marysville, WA
National Provider Identifier
1417455239
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
P161553745 Issued in WA
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

Updated by the provider on Aug 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
P161553745WAMDPhysical 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.

Verify at the official NPI Registry.