Individual provider Active NPI

Johanna Brown, OT

  • Occupational Therapist
  • Mount Vernon, WA
National Provider Identifier
1588031850
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT60963058 Issued in WA
Practice address
320 Pacific PL
Mount Vernon, WA 98273-5463
Phone
(360) 416-7570
NPI assigned
Aug 21, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT.0004340 CO
Occupational Therapist 225X00000X OT60963058 WA Primary

Addresses

Primary practice location

320 Pacific PL
Mount Vernon, WA 98273-5463

Mailing address

320 Pacific PL
Mount Vernon, WA 98273-5463
Phone (720) 365-1959

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210212001918 WA Practitioner - Occupational Therapist in Private Practice 6103231758 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT.0004340COMDOccupational Therapist
OT60963058WAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Rehabilitation Group, PC Occupational Therapist CurrentSince May 24, 2021 Accepting new patients
Integrated Rehabilitation Group, PC CurrentSince May 24, 2021 Accepting new patients
Apple Physical Therapy LLC Occupational Therapist CurrentSince Feb 22, 2021 Accepting new patients
Apple Physical Therapy, LLC Occupational Therapist CurrentSince Feb 22, 2021 Accepting new patients
Skagit Preschool Association and Resource Center PastSince Sep 24, 2023 Accepting new patients

Locations

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

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

4220 Hoyt Ave
Everett, WA 98203
Phone (425) 258-5330

32030 23rd Ave S
Federal Way, WA 98003
Phone (253) 946-4852

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

130 Marvin Rd SE
Ste 203
Lacey, WA 98503
Phone (360) 456-3300

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

Organizations & group practices 5

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": "1440115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1588031850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 PACIFIC PL",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982735463",
            "telephone_number": "720-365-1959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 PACIFIC PL",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982735463",
            "telephone_number": "360-416-7570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JOHANNA",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-21",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CO",
            "license": "OT.0004340",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT60963058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; 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.