Mary E Spores

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT00004021 Issued in WA

Practice address

15436 Bel Red Rd
Ste 100
Redmond, WA 98052-5536

Phone

(425) 644-4100

Fax

(425) 644-4101

NPI assigned

Aug 30, 2006

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 identifiers 1

Other names 1

• Mary E Clauson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203379200000",
    "number": "1457461899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15436 BEL RED RD",
            "address_2": "STE 100",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980525536",
            "telephone_number": "425-644-4100",
            "fax_number": "425-644-4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15436 BEL RED RD",
            "address_2": "STE 100",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980525536",
            "telephone_number": "425-644-4100",
            "fax_number": "425-644-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPORES",
        "first_name": "MARY",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2008-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT00004021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "0202392",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "CLAUSON",
            "middle_name": "E",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kristina Marie Spice, MA
• Lary Gene Spiller, DC
• Spine Performance and Rehabilitation Center
• Rachel Diane Spint
• Grace Anne Sporer, BCBA
• Kathryn Zacheretti Spottswood, RD
• Joel Benjamin Spring, DPT
• Sophia Louise Springstead
• Manpreet Singh Sran, MD
• Varsha Sridhar, MD

• Occupational Therapist in Redmond, WA
• Providers in Redmond, WA by specialty
• Occupational Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; 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.