Individual provider Active NPI

Kelley Anne Couvillion, MS OTR/L

  • Occupational Therapist
  • Seattle, WA
National Provider Identifier
1639415730
Registry record updated Dec 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
00003235 Issued in WA
Practice address
2445 3Rd Ave S
Seattle, WA 98134-1923
Phone
(206) 252-7187
NPI assigned
Dec 17, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2012

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 00003235 WA Primary

Addresses

Primary practice location

2445 3Rd Ave S
Seattle, WA 98134-1923

Mailing address

1710 15TH Ave S
Seattle, WA 98144-4212
Phone (206) 328-9888

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
00003235WAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1355702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355702400000",
    "number": "1639415730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 15TH AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981444212",
            "telephone_number": "206-328-9888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2445 3RD AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981341923",
            "telephone_number": "206-252-7187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUVILLION",
        "first_name": "KELLEY",
        "middle_name": "ANNE",
        "credential": "MS OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-17",
        "last_updated": "2012-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "00003235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2012; 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.