Freeborn Wellness, PLLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT60068984 Issued in WA

Legal business name

FREEBORN WELLNESS, PLLC

Practice address

6920 43Rd Loop SE
Lacey, WA 98503-7114

Phone

(360) 584-3803

NPI assigned

Jan 20, 2016

Last updated

Jun 3, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Andrea Freeborn, MSOT, OTR/LNPI 1982007035

Title

Occupational Therapist/Owner

Phone

(360) 584-3803

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Andrea Freeborn, MSOT, OTR/L

  • Community Health Worker
  • Olympia, WA
  • NPI 1982007035
  Medicare reassignment Care Compare group Authorized official
• Jennifer Mary Altimari, OT

  • Occupational Therapist
  • Olympia, WA
  • NPI 1871076000
  Medicare reassignment Care Compare group NPD
• Kaylee Jean Cook, MSOT

  • Occupational Therapist
  • Centralia, WA
  • NPI 1215449079
  Medicare reassignment Care Compare group NPD
• Adam Lutz

  • Physical Therapist
  • Centralia, WA
  • NPI 1962063511
  Medicare reassignment Care Compare group NPD
• Xiangdong Tang, DPT

  • Physical Therapist
  • Centralia, WA
  • NPI 1770308314
  Medicare reassignment Care Compare group NPD
• Justin Thompson

  • Physical Therapist
  • Clearfield, UT
  • NPI 1912268459

  WA

  Medicare reassignment Care Compare group NPD
• Christopher Kelly, LMT

  • Massage Therapist
  • Centralia, WA
  • NPI 1063150506
  NPD
• Samantha Rossi Perdue, DPT

  • Physical Therapist
  • Lacey, WA
  • NPI 1083015473
  NPD (past)

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

{
    "created_epoch": "1453248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464912000000",
    "number": "1518324649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6920 43RD LOOP SE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985037114",
            "telephone_number": "360-584-3803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6920 43RD LOOP SE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985037114",
            "telephone_number": "360-584-3803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEBORN WELLNESS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-20",
        "last_updated": "2016-06-03",
        "status": "A",
        "authorized_official_last_name": "FREEBORN",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST/OWNER",
        "authorized_official_telephone_number": "360-584-3803",
        "authorized_official_credential": "MSOT, OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT60068984",
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225XM0800X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2042848",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan Lynn Frasier, FNP
• Holly Marie Frazier, LMP
• Fred Meyer Stores Inc (QFC Pharmacy)
• Fred Meyer Stores Inc
• Gary J Fredericksen, LICSW
• Sami J Freedman
• Hannah Freeman
• Rachel E Freer, MA, LMHC, MHP
• Qin Friend
• Lucille Fuchs

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2016; 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.