Individual provider Active NPI

Sarah Rachel Bonnen Glick, OTR/L

  • Occupational Therapist
  • Bothell, WA
National Provider Identifier
1508504820
Registry record updated Jul 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT61276760 Issued in WA
Practice address
18504 Bothell Way NE
Bothell, WA 98011-1927
Phone
(425) 481-1933
NPI assigned
May 25, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT61276760 WA Primary

Addresses

Primary practice location

18504 Bothell Way NE
Bothell, WA 98011-1927

Mailing address

10428 128TH Ave NE
Kirkland, WA 98033-4734
Phone (919) 604-5682

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221223000685 WA Practitioner - Occupational Therapist in Private Practice 1052781606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Rehabilitation Group PCGroup PAC ID 0042111718, 192 clinicians

Practice addresses (Care Compare)

18606 Bothell Way NE
Bothell, WA 98011-1929
Phone (425) 686-7657

403 W Stanley St
Granite Falls, WA 98252-8631
Phone (360) 691-4835

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT61276760WAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Rehabilitation Group, PC Occupational Therapist CurrentSince Dec 5, 2022 Accepting new patients
Integrated Rehabilitation Group, PC CurrentSince Dec 5, 2022 Accepting new patients

Locations

875 Wesley St
Ste 220
Arlington, WA 98223
Phone (425) 337-3166

10207 19th Ave SE
Everett, WA 98208
Phone (425) 337-3166

403 W Stanley St
Granite Falls, WA 98252
Phone (360) 691-4835

4220 132nd St SE
Ste 101
Mill Creek, WA 98012
Phone (425) 316-8046

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1653436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657497600000",
    "number": "1508504820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10428 128TH AVE NE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980334734",
            "telephone_number": "919-604-5682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18504 BOTHELL WAY NE",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980111927",
            "telephone_number": "425-481-1933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLICK",
        "first_name": "SARAH",
        "middle_name": "RACHEL BONNEN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-25",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT61276760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bothell, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.