Individual provider Active NPI

Caitlin Irene Mitchell, MSOT, OTR/L

  • Pediatric Occupational Therapist
  • Gig Harbor, WA
National Provider Identifier
1497371611
Registry record updated Jun 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT60934906 Issued in WA
Practice address
5334 Olympic Dr Ste 101
Gig Harbor, WA 98335-1722
Phone
(253) 853-5155
Fax
(253) 853-5150
NPI assigned
Jun 23, 2020
Last updated
Jun 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X OT60934906 WA Primary

Addresses

Primary practice location

5334 Olympic Dr Ste 101
Gig Harbor, WA 98335-1722

Mailing address

5334 Olympic Dr Ste 101
Gig Harbor, WA 98335-1722
Phone (253) 853-5155

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210601000517 WA Practitioner - Occupational Therapist in Private Practice 8628477320 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT60934906WAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Mar 1, 2021 Accepting new patients
Multicare Health System CurrentSince Mar 1, 2021 Accepting new patients
Multicare Health System Current Accepting new patients
Harbor Children's Therapy, L.L.C. PastSince Jun 28, 2020 Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

200 Lilly Rd NE
Ste C
Olympia, WA 98506
Phone (360) 918-8336

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1592870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1497371611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5334 OLYMPIC DR STE 101",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983351722",
            "telephone_number": "253-853-5155",
            "fax_number": "253-853-5150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5334 OLYMPIC DR STE 101",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983351722",
            "telephone_number": "253-853-5155",
            "fax_number": "253-853-5150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "CAITLIN",
        "middle_name": "IRENE",
        "name_prefix": "Mrs.",
        "credential": "MSOT, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-23",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "WA",
            "license": "OT60934906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gig Harbor, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.