Shannon Evette Tartaglia, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OC0001169 Issued in WA

Practice address

13301 SE 79TH PL Unit A406
Newcastle, WA 98059-3236

Phone

(425) 687-7691

Fax

(425) 793-4594

NPI assigned

Sep 8, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Shannon Evette Stutzman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1283904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283904000000",
    "number": "1649587973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13301 SE 79TH PL UNIT A406",
            "city": "NEWCASTLE",
            "state": "WA",
            "postal_code": "980593236",
            "telephone_number": "425-687-7691",
            "fax_number": "425-793-4594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13301 SE 79TH PL UNIT A406",
            "city": "NEWCASTLE",
            "state": "WA",
            "postal_code": "980593236",
            "telephone_number": "425-687-7691",
            "fax_number": "425-793-4594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARTAGLIA",
        "first_name": "SHANNON",
        "middle_name": "EVETTE",
        "name_prefix": "Mrs.",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-08",
        "last_updated": "2010-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WA",
            "license": "OC0001169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "STUTZMAN",
            "middle_name": "EVETTE",
            "prefix": "MRS.",
            "credential": "COTA/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Occupational Therapy Assistant in Newcastle, WA
• Providers in Newcastle, WA by specialty
• Occupational Therapy Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2010; 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.