Individual provider Active NPI

Amy Susannah Walters, OCCUPATIONAL THERAPY

  • Occupational Therapist
  • Tacoma, WA
National Provider Identifier
1598734360
Registry record updated Feb 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT00002912 Issued in WA
Practice address
9040A Jackson Avenue
Tacoma, WA 98431
Phone
(253) 968-7924
NPI assigned
Mar 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2019

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 OT00002912 WA Primary

Addresses

Primary practice location

9040A Jackson Avenue
Tacoma, WA 98431

Mailing address

3115 N 9TH St
Tacoma, WA 98406-6222
Phone (425) 499-4785

Other practice location 1

Edis - Hhu
CMR 470
Apo, AE 09165
DE
Phone 011496181888213

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OT00002912WAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549497600000",
    "number": "1598734360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3115 N 9TH ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984066222",
            "telephone_number": "425-499-4785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040A JACKSON AVENUE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "98431",
            "telephone_number": "253-968-7924"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "EDIS - HHU",
            "address_2": "CMR 470",
            "address_purpose": "LOCATION",
            "city": "APO",
            "state": "AE",
            "postal_code": "09165",
            "country_code": "DE",
            "telephone_number": "011496181888213",
            "country_name": "Germany",
            "address_type": "FGN"
        }
    ],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "AMY",
        "middle_name": "SUSANNAH",
        "name_prefix": "Ms.",
        "credential": "OCCUPATIONAL THERAPY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-15",
        "last_updated": "2019-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT00002912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.