Individual provider Active NPI

Mitchell Lee Riddle, OT

  • Occupational Therapist
  • Spokane Valley, WA
National Provider Identifier
1649786047
Registry record updated May 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT60825215 Issued in WA
Practice address
16528 E Desmet CT Ste B2200
Spokane Valley, WA 99216-3522
Phone
(509) 944-8920
Fax
(509) 462-8011
NPI assigned
Dec 20, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2025

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 OT60825215 WA Primary

Addresses

Primary practice location

16528 E Desmet CT Ste B2200
Spokane Valley, WA 99216-3522

Mailing address

PO Box 31001-4114
Pasadena, CA 91110-4114

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, ID2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180212001412 WA Practitioner - Occupational Therapist in Private Practice 4082974019 Reassigns benefits to 1 organization
I20260504007459 ID Practitioner - Occupational Therapist in Private Practice 4082974019 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1593 E Polston Ave
Post Falls, ID 83854-5326

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Rehabilitation Associates, PLLC Occupational Therapist CurrentSince Jan 1, 2020 Accepting new patients
Providence Health & Services Washington CurrentSince May 1, 2025 Accepting new patients
Providence Health & Services Washington CurrentSince May 1, 2025 Accepting new patients
Inspire Physical & Hand Therapy Spokane Inc. P.S. Occupational Therapist Past Accepting new patients
Summit Rehab Valley Corporation PastSince Jan 1, 2020 Accepting new patients
Providence Health & Services - Washington Past Accepting new patients

Locations

1200 E Columbia Ave
Colville, WA 99114
Phone (509) 684-3701

820 S McClellan St
Ste 118
Spokane, WA 99204
Phone (509) 747-3147

407 E 2nd Ave
Ste 100
Spokane, WA 99202
Phone (509) 455-6002

9911 N Nevada St
Ste A
Spokane, WA 99218
Phone (509) 960-7340

16528 E Desmet Ct
Ste B2200
Spokane Valley, WA 99216
Phone (509) 944-8920

Organizations & group practices 7

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": "1513728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747612800000",
    "number": "1649786047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31001-4114",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911104114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16528 E DESMET CT STE B2200",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992163522",
            "telephone_number": "509-944-8920",
            "fax_number": "509-462-8011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDDLE",
        "first_name": "MITCHELL",
        "middle_name": "LEE",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-20",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT60825215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane Valley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.