Active NPI
Janell Dyball, OTR/L
- Pediatric Occupational Therapist
- Spokane Valley, WA
National Provider Identifier
1669544854
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- OT00003671
- Practice address
- 9212 E Montgomery Ave
#103
Spokane Valley, WA 99206-4239 - Phone
- (509) 922-0855
- Fax
- (509) 921-0050
- NPI assigned
- Nov 14, 2006
- Last updated
- Oct 24, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | OT00003671 | WA | Primary |
Addresses
Primary practice location
9212 E Montgomery Ave
#103
Spokane Valley, WA 99206-4239
Mailing address
3924 E 28TH Ave
Spokane, WA 99223-5715
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8455644 | Medicaid | WA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| OT00003671 | WA | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physiotherapy Associates | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193184000000",
"number": "1669544854",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3924 E 28TH AVE",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992235715"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9212 E MONTGOMERY AVE",
"address_2": "#103",
"city": "SPOKANE VALLEY",
"state": "WA",
"postal_code": "992064239",
"telephone_number": "509-922-0855",
"fax_number": "509-921-0050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DYBALL",
"first_name": "JANELL",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-14",
"last_updated": "2007-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "WA",
"license": "OT00003671",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8455644",
"state": "WA"
}
],
"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 Oct 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.