Individual provider Active NPI

Brenda McKey, OT

  • Pediatric Occupational Therapist
  • Olympia, WA
National Provider Identifier
1538580956
Registry record updated Jan 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
00001300 Issued in WA
Practice address
410 Providence LN NE
Olympia, WA 98506-6927
Phone
(360) 493-4350
Fax
(360) 493-7977
NPI assigned
Jan 2, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2014

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 00001300 WA Primary

Addresses

Primary practice location

410 Providence LN NE
Olympia, WA 98506-6927

Mailing address

410 Providence LN NE
Olympia, WA 98506-6927
Phone (360) 493-4350

Other identifiers 1

IdentifierTypeStateIssuer
910567732MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220321001128 WA Practitioner - Occupational Therapist in Private Practice 3779978291 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00001300WAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Jan 28, 2022 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Jan 28, 2022 Accepting new patients

Locations

505 S 336th St
Ste 210
Federal Way, WA 98003
Phone (253) 383-5777

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 3

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": "1388620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388620800000",
    "number": "1538580956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 PROVIDENCE LN NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985066927",
            "telephone_number": "360-493-4350",
            "fax_number": "360-493-7977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 PROVIDENCE LN NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985066927",
            "telephone_number": "360-493-4350",
            "fax_number": "360-493-7977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKEY",
        "first_name": "BRENDA",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-02",
        "last_updated": "2014-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "WA",
            "license": "00001300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "910567732",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2014; 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.